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Femoral Fracture in Pregnancy: A Case Report and Review of Data from the Literature
Ștefan-Dragoș Tîrnovanu1,2, Elena Cojocaru3, Bogdan Veliceasa1,2
1Department of Orthopedics and Traumatology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Background:
Orthopedic trauma during pregnancy is a rare yet complex medical challenge, impacting both maternal and fetal health. Among these, femoral fractures are particularly uncommon but require careful management to minimize maternal and fetal risks.
Methods:
We report the case of a 28-year-old woman, gravida 4, para 3, at 40 weeks of gestation, who sustained a left mid-femoral diaphyseal fracture following a low-energy fall. A multidisciplinary team approach, including obstetric, orthopedic, anesthetic, and neonatal specialists, was employed. Preoperative imaging by X-ray was performed under lead-apron protection. The patient underwent an emergency C-section, followed by closed reduction and internal fixation with an intramedullary nail.
Results:
The surgical intervention was successful, with minimal radiation exposure. Postoperative management included thromboprophylaxis, calcium, vitamin D supplementation, and physiotherapy. The patient recovered well, achieving fracture healing within three months. Postpartum bone density assessment was recommended, suspecting pregnancy- and lactation-associated osteoporosis.
Conclusions:
Managing femoral fractures during pregnancy necessitates a balance between maternal and fetal well-being. A collaborative, multidisciplinary approach ensures optimal outcomes. Early surgical intervention, proper radiation precautions, and postpartum bone health assessment are crucial in these cases. Further research is needed to understand risk factors and preventive strategies for pregnancy-associated osteoporosis.
