[About of 82 obstetrical astro-articular injuries of the new-born (excepting brachial plexus palsies). Limits of initial therapeutic aggression and follow-up of evolution, particulary concerning traumatic separation of upper femoral epiphysis (author's transl)].
Obstetrical fracture has not a bad character, because of quick healing and, above all, because of extraordinary modelling by growth. The authors record 33 fractures of long bones which confirm this good prognosis. 20 birth fractures of the clavicule associated with brachial plexus palsies are recorded on account of their pathogenic, diagnostic and therapeutic intricacies. Prognosis of obstetrical traumatic separation of the epiphysis (epiphysiolysis) would be more preoccupying. This feeling is not given off the series of 28 observations recorded which conern 13 upper humeral, 6 lower humeral epiphysis, 1 of 6 upper femoral and 1 lower femoral epiphysis, of upper and lower of tibia. Diagnosis is not so easy, helped, if necessary, by arthrography. The clinical aspect of "pseudo-dislocation" associated with periostal callus, early appearing (about on the 10th day) rectifies diagnosis. Early treatment, as little aggressive as possible, (essentially orthopedic management by tractions along the axis of limb, giving up an anatomy as close as possible to normality) avoids sequellae, not existing at shoulder nor elbow and, if they exist, extremely decreased at hip, and the surgical management of which is always delayed. Initially good result of one birth dislocation of cervical spine, precedently recorded is considerably impaired.
D001720:Birth Injuries / Q000628:therapy*; D001917:Brachial Plexus / Q000293:injuries; D002648:Child; D002968:Clavicle / Q000293:injuries; D004551:Elbow Joint; D005264:Femoral Fractures / Q000209:etiology / Q000628:therapy; D006618:Hip Dislocation, Congenital / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D004204:Joint Dislocations / Q000209:etiology / Q000628:therapy; D012783:Shoulder Dislocation / Q000209:etiology / Q000628:therapy
A propos de 82 traumatismes obstétricaux ostéo-articulaires du nouveau-né (paralysies du plexus brachial exceptées). Limites de l'agression thérapeutique initiale et surveillance de l'évolution, en particulier dans les décollements épiphysaires de l'extrémité supérieure fémorale.