Femoral Fracture in Pregnancy: A Case Report and Review of Data from the Literature

TL;DR

A rare case of femoral fracture during pregnancy is reported, highlighting the need for multidisciplinary care to ensure safe outcomes for both mother and baby.

Contribution

This case report provides insights into managing femoral fractures during pregnancy using a multidisciplinary approach and emphasizes postpartum bone health assessment.

Findings

Successful surgical management of a femoral fracture during late pregnancy was achieved with minimal radiation exposure.

Postpartum bone density assessment is recommended due to suspected pregnancy- and lactation-associated osteoporosis.

A multidisciplinary team approach is crucial for optimal maternal and fetal outcomes in such cases.

Abstract

Background: Orthopedic trauma during pregnancy is a rare yet complex medical challenge, impacting both maternal and fetal health. Among these, femoral fractures are particularly uncommon but require careful management to minimize maternal and fetal risks. Methods: We report the case of a 28-year-old woman, gravida 4, para 3, at 40 weeks of gestation, who sustained a left mid-femoral diaphyseal fracture following a low-energy fall. A multidisciplinary team approach, including obstetric, orthopedic, anesthetic, and neonatal specialists, was employed. Preoperative imaging by X-ray was performed under lead-apron protection. The patient underwent an emergency C-section, followed by closed reduction and internal fixation with an intramedullary nail. Results: The surgical intervention was successful, with minimal radiation exposure. Postoperative management included thromboprophylaxis, calcium, vitamin D supplementation, and physiotherapy. The patient recovered well, achieving fracture healing within three months. Postpartum bone density assessment was recommended, suspecting pregnancy- and lactation-associated osteoporosis. Conclusions: Managing femoral fractures during pregnancy necessitates a balance between maternal and fetal well-being. A collaborative, multidisciplinary approach ensures optimal outcomes. Early surgical intervention, proper radiation precautions, and postpartum bone health assessment are crucial in these cases. Further research is needed to understand risk factors and preventive strategies for pregnancy-associated osteoporosis.

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