Clinical and diagnostic aspects of nontraumatic fractures in metabolic bone disease of prematurity


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Abstract

Objective. To determine the incidence and analyze the clinical and diagnostic characteristics of the metabolic bone disease of prematurity (MBDP) presenting with non-traumatic fractures. Materials and methods. The study was conducted in 2013-2017 and comprised all premature infants with MBDP-associated bone fractures, who had no surgical diseases. Results. Fractures were diagnosed in 7 children; femoral and rib fractures were more common than humerus fractures. All children received total parenteral nutrition lasting from 9 to 43 (median 19) days; in 5 of them, enteral nutrition did not meet their nutritional needs. In the 1st month of life, all infants had severe hypophosphatemia; in 5 patients the level of alkaline phosphatase increased. Conclusion. MBDP-associated bone fractures were observed in 2.1% of children with birth weight less than 1500g (6.25% with ELBW; 0.4% with VLBW). All children had multiple risk factors for MBDP. In 3 infants, bone fractures were diagnosed belatedly, when they were in the stage of consolidation.

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About the authors

Marina V. Kukhartseva

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia; I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: m_kukhartseva@oparina4.ru
neonatologist, Department of Pathology of Newborns and Premature Babies; PhD student at the Department of Neonatology

Marina V. Narogan

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia; I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: m_narogan@oparina4.ru
MD, leading researcher, Department of Pathology of Newborns and Premature Babies; professor, Department of Neonatology

Alina V. Kozlova

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia

Email: av_kozlova@oparina4.ru
radiologist, Department of Radiology

Irina I. Ryumina

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia

Email: i_ryumina@oparina4.ru
MD, head of the Department of Pathology of Newborns and Premature Babies

Irina V. Orlovskaya

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia

Email: i_orlovskaya@oparina4.ru
PhD, clinical care supervisor, Department of Pathology of Newborn and Premature Babies

Alexandra Yu. Parnas

N.I. Pirogov RNRMU

5th year student, Faculty of Pediatrics

Olga E. Semenova

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

5th year student, Medical Faculty

Viktor V. Zubkov

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia; I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: v_zubkov@oparina4.ru
MD, professor, head of the Department of Neonatology and Pediatrics; professor, Department of Neonatology

Dmitry N. Degtyarev

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia

Email: d_degtiarev@oparina4.ru
MD, professor, deputy director for research

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