Obstetric Neonatal Femur Fracture During Emergency Cesarean Section for Breech: A Case Report.

Abstract

Introduction: Neonatal Obstetric fractures are rare birth injuries that newborns sustained from trauma during delivery and birth process. Long bone fractures are common in vaginal breech deliveries. A cesarean section is considered a relatively safe and preferred mode of delivery of breech fetuses to prevent birth trauma and decrease the risk of fetal head entrapment; nevertheless, it can lead to femur fracture in newborn rarely.

Case report: A 3915 g male child born at 38 weeks and 4 days of gestation to a primigravida aged 31 years by emergency Lower Segment Cesarean Section for Premature Rupture of Membrane with breech presentation. During extraction, the newborn sustained a fracture to his right femur shaft. X-rays confirmed the diagnosis. The fracture was treated successfully with a toe-groin cast for 25 days with complete healing.

Conclusion: As compared to vaginal breech delivery, cesarean section reduces the risk of traumatic birth injuries; however, it does not completely eliminate the possibility of birth injuries and long bone fractures in newborns. Orthopedic opinion must be sought, if the obstetrician and neonatologist suspect any birth trauma in difficult deliveries. Immobilization of the limb leads to complete healing of the fracture without any sequel.