Cesarean section and the risk of fractured femur.
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).
Toker
Asaf
A
Central Administration, Hadassah Medical Organization, Jerusalem, Israel. asaftoker@hadassah.org.il
Perry
Zvi H
ZH
Cohen
Eugen
E
Krymko
Hanna
H
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