Related Experiment Videos
Fractures and rickets in very low birth weight infants: conservative management and outcome
Insights
Very low birth weight infants with fractures and rickets show healing and bone maturation with nutritional support. Conservative management focusing on weight gain is effective for these VLBW infants.
Area of Science:
- Neonatal Medicine
- Pediatric Orthopedics
- Developmental Pediatrics
Background:
- Fractures and rickets (F/R) are common in acutely ill very low birth weight (VLBW) infants.
- Limited prospective longitudinal data exist on the clinical course of F/R in VLBW infants.
Purpose of the Study:
- To prospectively investigate the clinical course and outcomes of fractures and rickets in VLBW infants.
- To evaluate the relationship between nutritional intake, growth, and skeletal healing in affected VLBW infants.
Main Methods:
- Prospective longitudinal study of 78 VLBW infants during their first year of life.
- Radiographic assessment of F/R healing and remodeling.
- Monitoring of enteral intake, physical growth, and skeletal maturation (wrist ossification centers).
Main Results:
- Radiographic evidence of F/R healing and remodeling occurred in 25 affected VLBW infants.
- Healing correlated with increased enteral intake and physical growth.
- Skeletal maturation was linked to weight gain and normalized by one year, irrespective of orthopedic intervention.
- No skeletal deformities were observed at follow-up.
Conclusions:
- VLBW infants with F/R can be managed conservatively.
- Emphasis on nutritional support to promote weight gain is crucial for skeletal healing and maturation.
- Conservative management leads to favorable skeletal outcomes in VLBW infants with F/R.
Abstract:
Fractures and rickets (F/R) often occur in very low birth weight (VLBW less than 1500 g) infants who are acutely ill. However, there are no prospective longitudinal studies of the clinical course of F/R in these infants. In a prospective study of 78 VLBW infants during the first year after birth, radiographic evidence of healing and remodeling of F/R was noted in affected infants (n = 25) concurrent with increased enteral intake and physical growth, and regardless of whether specific orthopedic treatment was initiated. Skeletal maturation as indicated by the development of ossification centers at the wrists was directly related to weight gain, and was similar to term infants by 1 year. No infant had skeletal deformities on follow-up examination. We suggest that VLBW infants with F/R can be managed "conservatively," with emphasis on nutritional intake to achieve weight gain.