Introduction

Obstetric fractures usually occur after complicated births and are sent to paediatric orthopaedics for treatment and follow-up. Clavicle fractures represent the most common orthopaedic birth injury, involving approximately 0.2 to 3.5% of births.

Hypotheses

Caesarean delivery, elective or necessary, along with the type of presentation, may play a determinant role in the aetiology of obstetric fractures.

Materials and methods

We chose to do a retrospective study to determine possible risk factors for this type of injury that may manifest in either delivery. Our aim was to deepen our knowledge in order to have a better prediction and a better management of this condition. Data gathered included parity, gestity, type of delivery, presentation, shoulder dystocia, type of fracture, birth weight, and APGAR score.

Results

We followed 136 patients that were diagnosed with Allman type I clavicle fracture, 32 of them also having brachial plexus birth palsy (BPBP) type 1 (Duchenne-Erb). Natural birth with a pelvic presentation imposes a relative risk of 6.2 of associated pathology compared to cranial presentation. Caesarean delivery and cranial presentation increase the risk of related pathology by 5.04 compared to natural birth. Statistically, pelvic presentation is 5.54 times more likely to develop related pathology than cranial presentation. Type of delivery and presentation correlate with associated pathology of clavicle fractures.

Discussion and conclusion

Caesarean delivery brings risks for the newborn and should be practiced only when necessary. Predictive modeling in obstetrics in third-trimester evaluations may statistically predict risks of birth complications like fracture and BPBP.

中文翻译：

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小儿外科医生评估的剖宫产产科骨折和危险因素

介绍

产科骨折通常发生在复杂的分娩后，并被送往儿科骨科进行治疗和随访。锁骨骨折是最常见的骨科产伤，约占新生儿的 0.2% 至 3.5%。

假设

剖宫产，选择性的或必要的，连同表现的类型，可能在产科骨折的病因中起决定性作用。

材料和方法

我们选择进行一项回顾性研究，以确定在任一分娩过程中可能出现的此类损伤的可能风险因素。我们的目标是加深我们的知识，以便更好地预测和更好地管理这种情况。收集的数据包括产次、妊娠期、分娩类型、表现、肩难产、骨折类型、出生体重和 APGAR 评分。

结果

我们跟踪了 136 名被诊断为 Allman I 型锁骨骨折的患者，其中 32 名还患有 1 型臂丛神经分娩麻痹 (BPBP) (Duchenne-Erb)。与颅先露相比，盆腔先露的自然分娩产生相关病理的相对风险为 6.2。与自然分娩相比，剖腹产和颅先露使相关病理的风险增加 5.04。据统计，骨盆先露发生相关病理的可能性是颅先露的 5.54 倍。分娩类型和表现与锁骨骨折的相关病理相关。

讨论和结论

剖腹产会给新生儿带来风险，应仅在必要时进行。妊娠晚期评估中产科的预测模型可以统计预测骨折和 BPBP 等出生并发症的风险。