Dear Colleague,

Have you face a spontaneous femur fracture after CS delivery? ie without predisposing bone disease!

Are you sure it was spontaneous?

Sometimes during a difficult extraction of baby through CS femur fractures have been reported. Especially seen when the presentation is breech and the obstetrician has a difficult time extracting the baby and has to manipulate the baby a lot holding the lower limbs.

Femoral fractures after CS are ususally iatrogenic due to difficuty in extracting the baby. Otherwise multiple fracture can be seen in diseases like oseogenesis imperfecta

I have experience from a similar case too. The fracture was iatrogenic.

HI

In my experience most of the time it is iatrogenic. Usually in difficult breech extraction specially if the obstetrician has taken a small incision.

Dr Arif

I am also aware of another cause of iatrogenic femur fracture.

Caused by a NIBP cuff left on the limb of a very active growing preterm. The cuff kept inflating and deflating at intervals of 15 mins and with the neonate actively moving the limb, femur fracture resulted.

I beleive that it is iatrogenic too.

We had a case of trisomy 18 with a fracture humerus delivered by CS.