Skeletal Birth Injuries: Presentation, Management and Outcome at the University College Hospital, Ibadan

Abstract

Background: Birth injuries are not uncommon in newly born babies. Such injuries which are sometimes first detected by the parents after discharge of the baby from the hospital, often cause a lot of anxiety regarding the causes and prognosis. Objective: To describe the presentation of birth injuries, their treatment and prognosis. Design: A retrospective hospital-based study. Patients and Methods: Children aged one day to three weeks who were seen at the Orthopaedics and Trauma Department of the University College Hospital, Ibadan between January 1998 and December 2002 constituted the subjects of this review. Their case notes were retrieved and data extracted from them. Results: Thirty four babies comprising 18 males and 16 females were identified. Only 14 (41 percent) of them were delivered in the hospital. Twenty five (73.5 percent of the 34 were delivered by spontaneous vaginal delivery with vertex presentation while only seven (20.6 percent) and two (5.9 percent) were delivered by breech and Caesarean sections, respectively. There were 36 injuries of which brachial plexus injuries accounted for 24 (66.7 percent), while fractures accounted for the remaining cases. The fractures involved the clavicle in seven (58.3 percent) cases, the humerus in three (25 percent) and the femur in two (16.7 percent). A majority (79.2 percent) of those with brachial plexus injury made full recovery within 11 months while all the fractures healed within six weeks. Conclusion: The results show that most of the babies who suffered brachial plexus injury and fractures of the femur and humerus at birth, recovered fully with prompt management.

Keywords

• birth injury
• brachial plexus injury
• erb's palsy
• fracture