title: Cesarean section and the risk of fractured femur.
abstract: BACKGROUND
  The rate of cesarean section is increasing and in the United States recently exceeded 30% of all deliveries. Birth injuries during CS are relatively rare. Femur fractures have a very low incidence during both vaginal delivery and CS.
  
  
  OBJECTIVE
  To assess our 10 year experience (2008-1997) in managing fractured femur during CS, including a typical case.
  
  
  METHODS
  We reviewed the prevalence of femur fractures in two tertiary, academic, level one trauma center hospitals in Israel (Hadassah in Jerusalem and Soroka in Beer Sheva).
  
  
  RESULTS
  During the study period 221,939 deliveries occurred in both hospitals. Of these, 17.6% were cesarean sections (38,990 CS). Of the total number of deliveries, the incidence of femur fracture was 0.077 per 1000 deliveries (17 fractures), and the incidence of femur fracture during CS was 0.308 per 1000 CS (12 fractures).
  
  
  CONCLUSIONS
  Cesarean section increases the risk of femur fractures (P < 0.001) with an odds ratio of 11.26 (confidence interval 3.97-31.97).
authors.affiliation: Central Administration, Hadassah Medical Organization, Jerusalem, Israel. asaftoker@hadassah.org.il
authors.forename: Asaf
authors.initials: A
authors.lastname: Toker
authors.forename: Zvi H
authors.initials: ZH
authors.lastname: Perry
authors.forename: Eugen
authors.initials: E
authors.lastname: Cohen
authors.forename: Hanna
authors.initials: H
authors.lastname: Krymko
mesh_terms: D001720:Birth Injuries / Q000453:epidemiology*; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D018570:Risk Assessment