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Case Reports
. 2025 Apr 4;15(4):601.
doi: 10.3390/life15040601.

Femoral Fracture in Pregnancy: A Case Report and Review of Data from the Literature

Ștefan-Dragoș Tîrnovanu  1   2 , Elena Cojocaru  3 , Bogdan Veliceasa  1   2 , Norin Forna  1   4 , Adrian-Claudiu Carp  1   2 , Bogdan Puha  1   2 , Alexandru Filip  1   2 , Awad Dmour  1   2 , Dragoș-Cristian Popescu  1   2 , Ovidiu Alexa  1   2 , Sorana-Caterina Anton  5   6 , Mihaela-Camelia Tîrnovanu  5   6
Affiliations
Case Reports

Femoral Fracture in Pregnancy: A Case Report and Review of Data from the Literature

Ștefan-Dragoș Tîrnovanu et al. Life (Basel). .

Abstract

Background: Orthopedic trauma during pregnancy is a rare yet complex medical challenge, impacting both maternal and fetal health. Among these, femoral fractures are particularly uncommon but require careful management to minimize maternal and fetal risks.

Methods: We report the case of a 28-year-old woman, gravida 4, para 3, at 40 weeks of gestation, who sustained a left mid-femoral diaphyseal fracture following a low-energy fall. A multidisciplinary team approach, including obstetric, orthopedic, anesthetic, and neonatal specialists, was employed. Preoperative imaging by X-ray was performed under lead-apron protection. The patient underwent an emergency C-section, followed by closed reduction and internal fixation with an intramedullary nail.

Results: The surgical intervention was successful, with minimal radiation exposure. Postoperative management included thromboprophylaxis, calcium, vitamin D supplementation, and physiotherapy. The patient recovered well, achieving fracture healing within three months. Postpartum bone density assessment was recommended, suspecting pregnancy- and lactation-associated osteoporosis.

Conclusions: Managing femoral fractures during pregnancy necessitates a balance between maternal and fetal well-being. A collaborative, multidisciplinary approach ensures optimal outcomes. Early surgical intervention, proper radiation precautions, and postpartum bone health assessment are crucial in these cases. Further research is needed to understand risk factors and preventive strategies for pregnancy-associated osteoporosis.

Keywords: femoral shaft fracture in pregnancy; intramedullary nailing during pregnancy; multidisciplinary trauma management in pregnancy; pregnancy-associated osteoporosis; radiation safety in obstetric orthopedic surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Profile X-ray of the left thigh revealing a fracture of the middle third of the femur with translation of the fragments.
Figure 2
Figure 2
Postoperative anteroposterior view of the left thigh—proximal pole of the intramedullary anterograde nail fixed with one screw.
Figure 3
Figure 3
Postoperative anteroposterior view of the left thigh—distal pole of the intramedullary anterograde nail fixed statically with one screw.
See this image and copyright information in PMC

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