Bone Fractures in a Neonatal Intensive Care Unit

Abstract

Introduction: Fractures during the neonatal period are rare. Some fractures, especially long bones, may occur during birth. Moreover, neonates hospitalized in the Neonatal Intensive Care Unit have an increased risk of fractures for several reasons.
Objective: To evaluate the incidence and characterize fractures in newborns admitted in a tertiary Neonatal Intensive Care Unit.
Material and Methods: A retrospective analysis of the newborns admitted to the Neonatal Intensive Care Unit with a diagnosis at discharge of one or more bone fractures from January 1996 to June 2013.
Results: Eighty neonates had one or more fractures. In 76 (95%) infants the fractures were attributed to birth injury. The most common fracture was the clavicle fracture in 60 (79%) neonates, followed by skull fracture in 6 (8%). In two (2.5%) neonates, extremely low birth weight infants, fractures were interpreted as resulting from osteopenia of prematurity. Both had multiple fractures, and one of them with several ribs.
Conclusion: A change in obstetric practices allied to improvement premature neonate’s care contributed to the decreased incidence of fractures in neonatal period. But in premature infants the diagnosis may be underestimated, given the high risk of fracture that these infants present.