CC BY-NC-ND 4.0 · AJP Rep 2018; 08(03): e158-e160
DOI: 10.1055/s-0038-1667190
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Delayed Birth-Related Femur Fracture after Cesarean Section: A Case Report

Yuji Kanai
1  Department of Premature and Newborn, Iwaki Kyouritsu Hospital, Iwaki, Japan
2  Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima Medical University, Fukushima, Japan
,
Yoshinobu Honda
1  Department of Premature and Newborn, Iwaki Kyouritsu Hospital, Iwaki, Japan
,
Tsuyoshi Honda
3  Department of Obstetrics and Gynecology, Iwaki Kyouritsu Hospital, Iwaki, Japan
,
Minoru Sanpei
3  Department of Obstetrics and Gynecology, Iwaki Kyouritsu Hospital, Iwaki, Japan
› Author Affiliations
Funding None.
Further Information

Publication History

08 March 2018

14 June 2018

Publication Date:
07 August 2018 (online)

Abstract

Background Birth-related femur fractures are rare. They have been reported following difficult delivery and are commonly diagnosed immediately after birth or on the following day. However, some birth-related femur fractures are diagnosed several days after birth. Mechanisms underlying the development of delayed femur fracture are incompletely understood.

Case We report the case of a girl diagnosed with a left spiral femur fracture with associated edema and hypoesthesia on postpartum day 9. A nondisplacement femur fracture was identified on plain radiography at birth after cesarean section; however, it was undiagnosed due to the lack of symptoms. She was treated with plaster cast fixation; the physical examination at age 1 was normal. Herein, the diagnosis of birth-related femur fracture according to plain radiography findings suggests that the symptoms related to birth trauma develop several days after birth.

Conclusion Birth-related fracture should be considered in all neonatal femur fracture cases and in patients with no symptoms at birth. Neonates delivered in the breech presentation by cesarean section should be carefully monitored after birth. The findings of the present case further our understanding of the pathogenic mechanisms underlying delayed diagnosis of birth-related femur fracture.

Authors' Contributions

Y.K. managed the patient and was responsible for the concept, design, and writing of the final version of the manuscript. Y.H. managed the patient and made substantial contributions in drafting and revising the manuscript. T.H. and M.S. participated in the management of the patient and revised the manuscript. All authors have read and approved the final manuscript.