May 20th, 2018

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Long Bone Fractures Associated with Abdominal Breech Deliveries: A Report of Two Cases
Authors:  Natasha Gupta, M.D., Nirbhay Parashar, M.D., Richard Trester, M.D., and Josef Blankstein, M.D.
BACKGROUND: Birth-related injuries are a well-known complication of vaginal breech deliveries but are not anticipated during cesarean breech deliveries. However, long bone fractures in the neonate can result from delivery of the breech presentation by cesarean section.
CASES: We report 2 cases of long bone fractures that occurred during cesarean section for breech presentation. No underlying bone pathology or systemic illness could be identified in either case. There were no other predisposing risk factors for fractures except breech presentation. Both infants were managed with cast application and outpatient physical therapy and recovered without any residual deformity.

CONCLUSION: Obstetricians should be aware of the possibility of long bone fractures with abdominal breech deliveries. Their prompt recognition and conservative management, including physical therapy, can prevent bone deformities.
Keywords:  abdominal breech delivery, birth injuries, breech presentation, cesarean section, femoral neck fractures, femur neck fracture, humerus, humerus fracture, long bone fractures
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