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Case Reports in Orthopedics
Volume 2013, Article ID 962794, 4 pages
Case Report

Ankle Fracture Surgery on a Pregnant Patient Complicated by Intraoperative Emergency Caesarian Section

1Department of Orthopaedic Surgery, UC Irvine Medical Center, 101 The City Drive South Pavillion III, Orange, CA 92868, USA
2Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 E. 17th Street, New York, NY 10003, USA
3Department of Anesthesia, NYU Hospital for Joint Diseases, 301 E. 17th Street, New York, NY 10003, USA

Received 28 April 2013; Accepted 21 May 2013

Academic Editors: K. Erler, I. Han, P. Perrini, and T. Tsurumoto

Copyright © 2013 Ran Schwarzkopf et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report the case of a woman in the third trimester of pregnancy who sustained an ankle fracture dislocation that could not be adequately closed reduced. After discussions with the patient, her obstetrician, and the anesthesiologists, she was indicated for surgical fixation. A heart tone monitor was used to assess fetal health during the procedure. During surgical incision, the fetus went into distress, and an emergency caesarian section was performed. After delivery of the infant and abdominal closer, surgery was completed. Due to a cohesive team effort, both the patient and her infant had excellent outcomes. There are many important considerations in the surgical management of the pregnant patient with traumatic orthopaedic injuries. Of especial importance to the orthopaedic surgeon is the impact of patient positioning on uteroplacental blood flow. This report discusses factors that should be taken into account by any orthopaedist who plans to operate on a pregnant patient.