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Perinatal Femoral Fracture: A Ten-Year Observational Case Series Study
Vito Pavone1, Andrea Vescio1, Marco Montemagno1
1Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy.
Insights
Perinatal femoral fractures (PFF) in newborns are rare. Bryant
Area of Science:
- Neonatal care
- Pediatric orthopedics
- Birth trauma research
Background:
- Perinatal femoral fractures (PFF) are uncommon birth-related injuries.
- Bryant traction has shown success in treating PFF in young children.
- This study evaluates PFF management over a decade in Catania.
Purpose of the Study:
- To identify risk factors associated with PFF.
- To analyze diagnostic methods and treatment strategies for PFF.
- To assess the outcomes of PFF management in newborns.
Main Methods:
- Retrospective review of 15,628 neonates across four units.
- Data collection included birth weight, gestational age, presentation, and delivery mode.
- Fracture classification used the AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).
- Diagnosis involved clinical examination and X-ray; treatment was Bryant's skin traction.
- Follow-up extended to at least two years.
Main Results:
- Eight newborns with PFF were identified (5 males).
- Average birth weight was 2.656 kg; average gestational age was 37.5 weeks.
- Four cases were preterm births; five had cephalic presentations.
- Fracture types were AO PCCF 32-D/4.1 (3 cases) and 32-D/5.1 (5 cases).
- All patients achieved excellent outcomes.
Conclusions:
- Prematurity, low birth weight, and Cesarean section may be PFF risk factors.
- Bryant's skin traction is an effective treatment for PFF.
- Excellent outcomes are achievable with appropriate management.
Background:
perinatal femoral fractures (PFF) are relative rare birth-related fractures. Among treatment options, Bryant traction reported satisfactory outcomes in PFF of children under 3 years of age. The aim of this study is to assess the risk factors, diagnosis, management, and outcome in the 10-year multicentric experiences of all newborns treated for PFF in Catania city hospitals.
Methods:
15,628 children, hospitalized in four neonatal units, were retrospectively reviewed. The following data were collected: gender, birth weight, gestational age, presentation, mode delivery, and fracture type according to AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF). In each case, diagnosis was achieved after the clinical examination and X-Ray exam. Each patient underwent Bryant's skin traction of the affected limb, and was clinically followed for at least two years.
Results:
eight newborns were included in the study (five males). The average birth weight was 2.656 kg with a gestational age of 37.5 weeks; 4 cases were preterm birth; 5 patients had a cephalic presentation. According to the AO PCCF classification, three fractures were ranked 32-D/4.1 and five were 32-D/5.1. The entire cohort had an excellent outcome.
Conclusions:
prematurity, low birth weight, and caesarean section could be PFF risk factors. Bryant's skin traction is an effective option to achieve an excellent outcome.
