BACKGROUND: Bone fracture management in third-trimester pregnant patients is rare and poorly discussed in the literature. In the case of fractures that require orthopedic surgery in near-term pregnant women, clinicians should decide between operating before or after the delivery, carefully evaluating the health of the mother and fetus. CASE REPORT: A pregnant 41-year-old woman at 36 weeks' gestation had a traumatic midshaft displaced tibia and fibula fracture. A multispecialty team approach resulted in nonoperative treatment until delivery. The sudden spontaneous premature rupture of membranes led to a preterm cesarean section. Five days after cesarean section, the patient underwent surgery for open reduction and internal fixation with pins and plates. The patient recovered well and was discharged with her baby. CONCLUSION: The clinical and surgical management of bone fractures in pregnant women should be determined by a multispecialty team, and a tailored intervention should be chosen for each patient.
BACKGROUND: Bone fracture management in third-trimester pregnant patients is rare and poorly discussed in the literature. In the case of fractures that require orthopedic surgery in near-term pregnant women, clinicians should decide between operating before or after the delivery, carefully evaluating the health of the mother and fetus. CASE REPORT: A pregnant 41-year-old woman at 36 weeks' gestation had a traumatic midshaft displaced tibia and fibula fracture. A multispecialty team approach resulted in nonoperative treatment until delivery. The sudden spontaneous premature rupture of membranes led to a preterm cesarean section. Five days after cesarean section, the patient underwent surgery for open reduction and internal fixation with pins and plates. The patient recovered well and was discharged with her baby. CONCLUSION: The clinical and surgical management of bone fractures in pregnant women should be determined by a multispecialty team, and a tailored intervention should be chosen for each patient.
Authors: Robert D Barraco; William C Chiu; Thomas V Clancy; John J Como; James B Ebert; L Wayne Hess; William S Hoff; Michele R Holevar; J Gerald Quirk; Bruce J Simon; Patrice M Weiss Journal: J Trauma Date: 2010-07