Background . Medical information on the provision of emergency trauma care to newborns with fractures of tubular bones is scarce. Aim . This scientific review aimed to inform children's orthopedic traumatologists regarding the main mechanisms of injury, methods of diagnosis, and treatment of fractures of long tubular bones in newborns. Material and methods . The article presents a systematic analysis of 60 scientific works of domestic and foreign authors on topical aspects of fractures of long tubular bones in newborns from 1986 to 2018. For writing the literature review, we used modern electronic databases of medical information: PubMed, MEDLINE, Ulrich’s Periodicals Directory, DOAJ, Cyberleninka, and еLibrary. Results and discussion . Similarly from the analysis of scientific publications, the main mechanism of fractures of limb segments in newborns is intranatal trauma, in which the child can receive both during birth through the birth canal and during cesarean section. The predisposing factors for obtaining bone fractures are intrauterine osteopenia, congenital diseases of the digestive system, and prematurity. Fractures are diagnosed on the basis of clinical examination and results of ultrasound and X-ray studies of the injured limb. In the treatment of limb bone fractures, both conservative and surgical methods are used. In recent years, a tendency has been clearly observed in scientific publications, highlighting the ever-widening introduction into clinical practice of operational methods for stabilizing fractures of long tubular bones in newborns, including using the techniques of transosseous osteosynthesis. Conclusion . The presented article fills the existing gap of summarizing scientific publications on the treatment of fractures of limbs in newborns.

https://journals.eco-vector.com/turner/article/download/10207/8539

Fractures of long tubular bones in newborns: mechanisms of injuries, methods of diagnosis, and treatment

Introduction. Cerebro-costo-mandibular syndrome (CCMS) is a rare disorder,
 with only 75 cases described in the literature to date. CCMS is characterized
 by association of micrognathia and specific multiple rib defects. It is
 accompanied by mental deficiency in considerable number of cases. Sometimes,
 there are associated anomalies and problems, such as spine deformities,
 brain, heart, kidney or ear anomalies, feeding difficulties, delayed
 psychomotor development, and growth impairment. Depending on severity of
 deformities and consecutive respiratory insufficiency, in about 35-50% of
 CCMS cases, death occurs during the first year of life. These cases are
 referred to as severe types of CCMS. Case Outline. In this paper we present a
 female infant with severe type of CCMS. Diagnosis was established in the
 first day of life, based on micrognathia and findings of posterior rib-gap
 defects on the chest X-ray, accompanied by dyspnea. Progressive severe
 respiratory insufficiency caused by chest and air-way deformities and
 exacerbated by episodes of pneumonia, led to respiratory failure and death at
 the age of 7.5 months. Conclusion. CCMS should be considered in every infant
 with micrognathia and rib-gap defects on chest X-ray.

/pdf/a-case-of-severe-type-of-cerebro-costo-mandibular-syndrome-ry6gjdc71u.pdf

A case of severe type of cerebro-costo-mandibular syndrome.

Ribs

Maltraitance à enfants (sauf abus sexuels)

Primary bone tumors are rare, but osteosarcoma (OS) is the fourth commonest non-hematological primary neoplasm of the bone in the adolescence, and the other three commonest neoplasms, in descending order, are leukemia, brain tumors, and lymphoma. The commonest presenting complaints are swelling and aches. These tumors cannot be diagnosed without the help of radiology. There is a wide age range of these neoplasms commonly appearing in the second and third decade of life with a peak incidence in early teens. Males are affected more than females. The exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing bone diseases, environmental risk factors, and radiations, have been identified. If the bone tumors are viewed by clinical, radiological, and histopathological perspectives, the correct diagnosis can be made easily. Chemotherapy combined with surgery is the standard treatment modality with better 5-year survival rates. Elevated AKP is an important prognostic factor in this malignancy.

/pdf/differential-diagnosis-of-osteogenic-tumors-in-the-context-597q9ecixs.pdf

Differential Diagnosis of Osteogenic Tumors in the Context of Osteosarcoma

Introduction. Progress of labor in multiparous women usually is not
 accompanied with risk of any kind of birth trauma. Case Outline. We report a
 very rare case of rib fracture in a neonate during vaginal delivery in the
 39/40 week of gestation. The expulsion started spontaneously without any
 manipulation from the obstetrician. Live male newborn was delivered 4650 g.
 in weight, 55 cm long, with head circumference of 39 cm, Apgar score 9. The
 child was immediately examined by the neonatologist. Crepitations were
 palpable over the left hemithorax, and auscultatory on the left side
 inspiratory cracks. Finding was suspicious for rib fracture on the left side
 posteriorly and brachial plexus palsy, while other findings were normal.
 X­ray finding was inconclusive, but suspicious for fracture of the 4th, 5th,
 and 6th left rib posteriorly, without dislocation of bone fragments. There
 were no signs of pneumothorax. Dorsal position of the newborn was considered
 sufficient, accompanied with analgetics. X­ray was scheduled in a week
 because formation of the calus would be the only objective sign of previous
 rib fracture. On the control X­ray fracture lines were clearly visible on the
 3rd, 4th, 5th, 6th and 7th rib posteriorly, without dislocation of bone
 fragments with initial calus formation. The child was discharged from
 hospital in good condition after two weeks, for further outpatient care.
 Conclusion. With timely diagnostics of this very rare intrapartal fracture,
 adequate treatment, dorsal position and close control of clinical condition
 of the newborn, serious and potentially life threatening complications can be
 avoided.

/pdf/diagnosis-and-treatment-of-rib-fracture-during-spontaneous-103ix9rx73.pdf

Diagnosis and treatment of rib fracture during spontaneous vaginal delivery

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Diagnosis and treatment of rib fracture during spontaneous vaginal delivery