Skip to main content
Erschienen in: Pediatric Radiology 5/2007

01.05.2007 | Original Article

Can classic metaphyseal lesions follow uncomplicated caesarean section?

verfasst von: AnnaMarie O’Connell, Veronica B. Donoghue

Erschienen in: Pediatric Radiology | Ausgabe 5/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Classic metaphyseal lesion (CML) is the term given to a fracture that most often occurs in the posteromedial aspect of the distal femur, proximal tibia, distal tibia, and proximal humerus in infants; this finding is strongly associated with non-accidental injury.

Objective

To demonstrate that the CML may occur following simple lower segment caesarean section (LSCS).

Materials and methods

A review of 22 years of an obstetric practice that delivers 8,500 babies per year.

Results

We identified three neonates born by elective LSCS, each with distal femoral metaphyseal fractures on postpartum radiographs. All caesarean sections were elective and uncomplicated. External cephalic version was not employed preoperatively. Postpartum radiographs demonstrated a fracture of the distal femoral metaphysis in each neonate, typical of a CML.

Conclusion

We propose that a CML can occur in the setting of a simple, elective and uncomplicated LSCS where no external cephalic version is employed.
Literatur
1.
Zurück zum Zitat Caffey J (1957) Some traumatic lesions in growing bones other than fractures and dislocations: clinical and radiologic features. Br J Radiol 30:225–238PubMedCrossRef Caffey J (1957) Some traumatic lesions in growing bones other than fractures and dislocations: clinical and radiologic features. Br J Radiol 30:225–238PubMedCrossRef
2.
Zurück zum Zitat Kleinman PK, Marks SC, Blackbourne B (1986) The metaphyseal lesion in abused infants: a radiologic-histopathologic study. AJR 146:895–905PubMed Kleinman PK, Marks SC, Blackbourne B (1986) The metaphyseal lesion in abused infants: a radiologic-histopathologic study. AJR 146:895–905PubMed
3.
Zurück zum Zitat Kleinman PK, Marks SC (1998) A regional approach to the classic metaphyseal lesion in abused infants: the distal femur. AJR 170:43–47PubMed Kleinman PK, Marks SC (1998) A regional approach to the classic metaphyseal lesion in abused infants: the distal femur. AJR 170:43–47PubMed
4.
Zurück zum Zitat Cumming WA (1979) Neonatal skeletal fractures. Birth trauma or child abuse? J Can Assoc Radiol 30:30–33PubMed Cumming WA (1979) Neonatal skeletal fractures. Birth trauma or child abuse? J Can Assoc Radiol 30:30–33PubMed
5.
Zurück zum Zitat Ehrenfest H (1922) Birth Injuries of the child. Appleton-Century-Crofts, p 208 Ehrenfest H (1922) Birth Injuries of the child. Appleton-Century-Crofts, p 208
6.
Zurück zum Zitat Camus M, Lefebvre G, Darbois Y et al (1985) Traumatismes obstetricaux du nouveau-ne. Enquete retrospective a propos de 20409 naissances. J Gynecol Obstet Biol Reprod (Paris) 14:1033–1044 Camus M, Lefebvre G, Darbois Y et al (1985) Traumatismes obstetricaux du nouveau-ne. Enquete retrospective a propos de 20409 naissances. J Gynecol Obstet Biol Reprod (Paris) 14:1033–1044
7.
Zurück zum Zitat Curran JS (1981) Birth-associated injury. Clin Perinatol 8:111–129PubMed Curran JS (1981) Birth-associated injury. Clin Perinatol 8:111–129PubMed
8.
Zurück zum Zitat Kleinman PK (1998) Diagnostic imaging of child abuse, 2nd edn. Mosby, St Louis, p 219 Kleinman PK (1998) Diagnostic imaging of child abuse, 2nd edn. Mosby, St Louis, p 219
9.
Zurück zum Zitat Lysack JT, Soboleski D (2003) Classic metaphyseal lesion following external cephalic version and cesarean section. Pediatr Radiol 33:422–424PubMed Lysack JT, Soboleski D (2003) Classic metaphyseal lesion following external cephalic version and cesarean section. Pediatr Radiol 33:422–424PubMed
10.
Zurück zum Zitat Carty H, Pierce A (2002) Non-accidental injury: a retrospective analysis of a large cohort. Eur Radiol 12:2919–2925PubMed Carty H, Pierce A (2002) Non-accidental injury: a retrospective analysis of a large cohort. Eur Radiol 12:2919–2925PubMed
11.
Zurück zum Zitat Kleinman PK, Marks SC, Blackbourne BD et al (1995) Inflicted skeletal injury: a postmortem radiologic-histopathologic study in 31 infants. AJR 165:647–650PubMed Kleinman PK, Marks SC, Blackbourne BD et al (1995) Inflicted skeletal injury: a postmortem radiologic-histopathologic study in 31 infants. AJR 165:647–650PubMed
12.
Zurück zum Zitat Lonergan GF, Baker AM, Boos SC et al (2003) From the archives of the AFIP. Child abuse: radiologic-pathologic correlation. Radiographics 23:811–845PubMedCrossRef Lonergan GF, Baker AM, Boos SC et al (2003) From the archives of the AFIP. Child abuse: radiologic-pathologic correlation. Radiographics 23:811–845PubMedCrossRef
13.
Zurück zum Zitat Kleinman PK, Nimkin K, Spevak MR et al (1996) Follow-up skeletal surveys in suspected child abuse. AJR 167:893–896PubMed Kleinman PK, Nimkin K, Spevak MR et al (1996) Follow-up skeletal surveys in suspected child abuse. AJR 167:893–896PubMed
14.
Zurück zum Zitat Nadas S, Gudinchet F, Reinberg O et al (1993) Predisposing factors in obstetrical fractures. Skeletal Radiol 22:195–198PubMedCrossRef Nadas S, Gudinchet F, Reinberg O et al (1993) Predisposing factors in obstetrical fractures. Skeletal Radiol 22:195–198PubMedCrossRef
Metadaten
Titel
Can classic metaphyseal lesions follow uncomplicated caesarean section?
verfasst von
AnnaMarie O’Connell
Veronica B. Donoghue
Publikationsdatum
01.05.2007
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 5/2007
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0445-x

Weitere Artikel der Ausgabe 5/2007

Pediatric Radiology 5/2007 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.