Abstract
Introduction
Neonatal fractures are often quite distressing to parents and medical teams involved. Their management can be daunting due to the small size of the patient, the concern of the new parents and the fear of the obstetric staff about litigation and deformity or long term disability of the neonate.
Aim
This study assesses the radiological and functional outcome of neonatal fractures up to two years post injury.
Methods
We reviewed the notes of neonates at our hospital who sustained fractures spanning a 4 year period.
Clavicle and humeral fractures were treated in a swaddling bandage for 3 weeks.
Femoral fractures were treated in a gallows traction for 2–3 weeks.
Xrays were taken once weekly.
Patients were examined two years following their injury and function of the affected limb was assessed and compared with the unaffected side.
Radiographs of the previously fractured bones were also taken at the 2 years follow up.
Results
Eighteen (18) neonates sustained fractures predominantly due to birth trauma.
There were four clavicle fractures, one fracture of a humerus, three femoral and 10 skull fractures.
All seven (7) patients extremity fractures healed satisfactorily clinically and radiologically, with no residual deformity, limb length discrepancy or functional impairment at 2 years follow up.
All parents were very satisfied with the outcome.
Discussion and Conclusion
Neonatal fractures occur in <1% of births. Causes include birth trauma and congenital bone disease. Neonates with fractures are referred for Orthopaedic management which can be intimidating due to the infrequency of management of this cohort of patients. In our study all of our neonates with long bone fractures had good radiological results and no functional deficit when reviewed after 2 year. Clinicians can be reassured that neonatal fractures have a propensity to heal rapidly without residual functional or radiological abnormality as long as alignment is grossly maintained initially.
