Birth-associated long-bone fractures

ObjectiveTo assess the incidence and outcome of neonatal long-bone fractures at a tertiary teaching hospital.MethodsA retrospective study of all neonates with long-bone fractures delivered at Jordan University Hospital between January 1, 2000, and December 31, 2010.ResultsAmong a total of 34 519 live births, 8 neonates had a long-bone fracture (incidence 0.23/1000 live births); of these, 6 had a femur fracture (0.17/1000 live births) and 2 had a humerus fracture (0.05/1000 live births). The route of delivery was emergency cesarean delivery for 6 infants, elective cesarean delivery for 1 infant, and the vaginal route for 1 infant. The mean birth weight was 2723 g. All neonates weighed more than 2200 g and their gestational age was more than 35 weeks, with the exception of 1 neonate born at 31 weeks weighing 1500 g. The mean time interval from birth to fracture diagnosis was 1.5 days. All fractures healed with no residual deformity.ConclusionEmergency cesarean delivery carries a higher risk of long-bone fracture than vaginal delivery. Prematurity, malpresentation, abnormal lie, and multiple pregnancies may predispose to long-bone fractures. The prognosis of birth-associated long-bone fractures is good.