Spontaneous Isolated Midtrimester Fracture Of Tibia And Fibula In A Normal Fetus With In Utero Healing And Good Long-term Outcome
Scheier, M., Peter, M., Hager, C., Lang, T., Barvinek, A., & MARTh, C. (2010). spontaneous isolated midtrimester fracture of tibia and fibula in a normal fetus with in utero healing and good long-term outcome. Fetal diagnosis and therapy, 28(1), 58–60. https://doi.org/10.1159/000312406
View Original Source →Abstract
We report a case of spontaneous intrauterine fracture of the right tibia and fibula in an otherwise healthy fetus at 20 weeks of gestation. The fracture healed in utero in an abnormal position. Postnatal development of the baby was normal with spontaneous correction of the angulation, and no underlying disease could be discovered. Spontaneous isolated fetal fractures are rare and need to be differentiated from fractures that occur due to trauma or underlying skeletal diseases.
Case Details
Disease Location
Fetus - right fibula and tibia
Personal Characteristics
31-year-old woman, gravida 3, para 2
Clinical Characteristics
Referred for ultrasound evaluation and counseling at 13+2 weeks of her second pregnancy because she had previously delivered a baby with prenatally unrecognized walker-warburg syndrome. First trimester sonography showed a normal fetus. Second ultrasound scan at 16 weeks showed a normal fetus. The third scan at 20 weeks of gestation revealed an isolated, obviously recent fracture of the distal right tibia and right fibula. At 27+5 weeks, callus formation was visible and the osseous fragments were joined in a defective position with an anterior angulation of 25°. Delivery was performed by caesarean section at 39+2 weeks. No abnormalities other than severe angulation of the right lower leg were detected at birth
Remission Characteristics
The child started walking at 10 months and since then has worn shoe lifts to compensate for the shortening of the right leg. The angulation of the tibia and fibula decreased over time. In the most recent examination, at 4 years of age, the right tibia showed an antecurvation of 7° and a valgus position of 9°. The right lower leg was 2.9 cm shorter than the left lower leg, which was compensated for with orighthopedic shoe lifts.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Non-Clinical Treatment
Shoe lifts