Reappraisal of Neonatal Greenstick Skull Fractures Caused by Birth Injuries: Comparison of 3-Dimensional Reconstructed Computed Tomography and Simple Skull Radiographs

Cho, Sung Min; Kim, Hyun Gi; Yoon, Soo Han; Chang, Ki‐Hong; Park, Moon Sung; Park, Yul-Hyun; Choi, Mi Sun

doi:10.1016/j.wneu.2017.09.168

Cited by 17 publications

(11 citation statements)

References 29 publications

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“…Skull fractures are rare in modern obstetrics (0.001‐0.01%), although they may be underestimated, as an incidence of 2.9% has also been reported . Considering the fact that the head in the majority of infants is the largest part of the body to pass the birth canal, and that it undergoes an almost extreme moulding during this passage, it is conceivable that some skull fractures may remain undetected.…”

Section: Introductionmentioning

confidence: 99%

“…Considering the fact that the head in the majority of infants is the largest part of the body to pass the birth canal, and that it undergoes an almost extreme moulding during this passage, it is conceivable that some skull fractures may remain undetected. Greenstick skull fractures are stated to be the most common, followed by depressed and linear type . Birth‐related skull fractures are associated with assisted vaginal delivery or caesarean after failed assisted vaginal delivery .…”

Section: Introductionmentioning

confidence: 99%

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Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

et al. 2020

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Aim Specific birth‐related fractures have been studied; underestimates might be a problem. We aimed to assess all fractures diagnosed as birth‐related as well as other neonatal fractures. Methods A population‐based study on all infants born in Sweden 1997‐2014; data were retrieved from the Swedish Health Registers (10th version of International Classification of Diseases. Outcome measures were birth‐related fractures (ICD‐10 P‐codes) and other neonatal fractures (ICD‐10 S‐codes). Results The overall fracture incidence was 2.9 per 1000 live birth (N = 5336); 92.6% had P‐codes and 7.4% (S‐codes). Some birth‐related fractures were diagnosed beyond the neonatal period. Other neonatal fractures could have been birth‐related. Clavicle fracture (88.8%) was associated with adverse maternal and infant anthropometrics and birth complications. The few neonates with rib fractures all had concomitant clavicle fracture. For skull fractures, a minor part was birth‐related and most were associated with accidents. Half of the long bone fractures were associated with accidents. Birth‐related femur fractures were associated with bone fragility risk factors. Five infants with abuse diagnoses had fractures: skull (4), long bone (2) and rib (1). Conclusion Birth‐related and other neonatal fractures are rarely diagnosed. Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

et al. 2020

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“…Head injury factors which included cephalohematoma, subgaleal hematoma, linear skull fracture, depressed skull fracture, greenstick skull fracture, epidural hemorrhage (EDH), subarachnoid hemorrhage, tentorial hemorrhage, falx hemorrhage, intracerebral hemorrhage, intraventricular hemorrhage, brain swelling, hypoxic injury were assessed by CT and MRI. Greenstick skull fracture analysis was according to the definitions and classification of Cho et al 7) Among the 73 neonates, the numbers of patients with linear skull fracture, depressed skull fracture, greenstick skull fracture were assessed. In those neonates with cephalohematoma, subgaleal hematoma, EDH, subarachnoid hemorrhage, tentorial hemorrhage, falx hemorrhage, hypoxic injury, lesions less than 0.5 cm were defined as Grade 0, lesions 0.5 to 1.0 cm as Grade 1, lesions 1.0 to 1.5 cm as Grade 2, and lesions greater than 1.5 cm as Grade 3.…”

Section: Methodsmentioning

confidence: 99%

“… 4 , 17) Additionally, recent advancement of ultrasound, magnetic resonance imaging (MRI) and computed tomograpy (CT) has enhanced diagnostic efficiencies. 2 , 3 , 7 , 18) Therefore, it is deemed that there is necessity for statistical investigation into the long-term neurodevelopmental prognostic factors such as perinatal factors and birth head injury factors.…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental Prognostic Factors in 73 Neonates with the Birth Head Injury

Kim

Cho

Yoon

et al. 2018

Korean J Neurotrauma

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ObjectiveThe objective of this study was to reinterpret the neurodevelopmental prognostic factors that are associated with birth head injury by performing a long-term follow-up.MethodsSeventy-three neonates with head injuries were retrospectively analyzed after a duration of 10.0±7.3 years to determine the correlations between perinatal factors, including gender, head circumference, gestational age, body weight, and mode of delivery, and head injury factors from radiologic imaging with social, fine motor, language, and motor developmental quotients.ResultsThere was a statistically significant difference between perinatal factors and head injury factors with respect to head circumference, body weight, gestational age, mode of delivery, Apgar scores at 1 min, cephalohematoma, subdural hemorrhage, subarachnoid hemorrhage, and hypoxic injury, but no direct correlation by regression analysis was observed between perinatal factors and developmental quotients. Of the head injury factors, falx hemorrhage showed a significant indirect relationship with the language and motor developmental quotients. Mode of delivery, subgaleal hematoma, cephalohematoma, greenstick skull fracture, epidural hemorrhage (EDH), tentorial hemorrhage, brain swelling, and hypoxic injury showed an indirect relationship with social development.ConclusionIn terms of perinatal factors and head injury factors, mode of delivery, subgaleal hematoma, cephalohematoma, greenstick skull fracture, EDH, tentorial hemorrhage, falx hemorrhage, brain swelling, and hypoxic injury displayed an indirect relationship with long-term development, and therefore these factors require particular attention for perinatal care.

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“…In another study comparing 101 newborn scalp swellings with plain X-ray and three-dimensional (3D) cranial CT, Cho et al stated that the incidence of skull lesions described as greenstick fractures was higher than that of the general population (9). In contrast, 3D CT is speculated to give approximately twice as high radiation as 2D CT. Consequently, we believe that rather than extended usage of 3D CT, 3D CT may better elaborate scalp swellings in newborns with neurological findings.…”

Section: █ Conclusionmentioning

confidence: 99%