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J Korean Soc Fract. 2003 Apr;16(2):292-298. Korean. Original Article. https://doi.org/10.12671/jksf.2003.16.2.292
Kim TS , Whang KS , Kim JH .
Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea. kimts@hanyang.ac.kr
Abstract

PURPOSE: Birth injury is any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those from hypoxia and mechanical factors. Risk factor of birth injuries have been reported to breech presentation, forcep delivery, cephalopelvic disproportion, dystocia, and high birth weight. But, because of preterm care and development of delivery method and Cesarian section, recently the rate of birth injury was decreasing and the articles about birth injuries in orthopaedic fields have not been much. We analyzed the data about birth injuries occurred during recent 11 years. MATERIALS AND METHODS: We reviewed the charts and patients the 17 patients (20 cases) of birth injuries including fracture, nerve injury during the delivery at Hanyang University hospital from Jan. 1991 to Dec. 2001. But, we excluded birth injury of head and abdomen. RESULTS: The number of fracture and nerve injuries on extrimities in our hospital were clavicle fracture 9 cases, brachial plexus injury 6 cases, femur fracture 3 cases, separation of distal femoral epiphysis 1 case, humerus fracture 1 case. Patients of clavicle fracture were born at mean intrauterine period 41.5 weeks and mean birth weight of the patients was 4.25 kg. Patients of brachial plexus injury were born at mean intrauterine period 39.5 weeks and mean birth weight of the patients was 4.42 kg. Three cases of femoral fracture were all due to breech position while cesarean operartion and one of these cases were born as ishiophagus. We found the distal femoral epiphyseal separation injury missed initially and diagnosed a kind of birth injuries through remarkable periosteal reaction. CONCLUSION: The birth injuries including clavicle fracture and brachial plexus injury are highly related to high birth weight at birth and the femur fractures are related to delivery maneuver in C-section and breech delivery. Strict observation and monitoring are required because occasionally the paralysis might be the sign of brachial plexus injury or pseudoparalysis due to fracture. By the adequate preterm care or preterm ultrasound check up, high weight delivery could be avoided and then the birth injury must be reduced.

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