Surgically treated fractures during pregnancy: fracture patterns, anesthetic strategy, radiation considerations, and maternal outcomes

Purpose: Fractures occurring during pregnancy pose unique challenges related to fetal safety, anesthesia management, and radiation exposure. This study aimed to evaluate fracture patterns, surgical strategies, anesthetic approaches, radiation exposure, and maternal–fetal outcomes in pregnant patients undergoing operative fracture treatment. Methods: A retrospective cohort study was conducted including pregnant patients treated for fractures between 2014 and 2023. Of the 30 identified patients, 19 who underwent surgical treatment were included in the analysis. Patients managed conservatively (n = 9), those with insufficient clinical and radiological data (n = 1), and patients with pathological fractures (n = 1) were excluded. Demographic characteristics, gestational age at injury, mechanism of trauma, fracture type, anesthesia modality, fluoroscopy exposure, fracture union time, complications, and obstetric outcomes were analyzed. Results: The mean maternal age was 29.8 years, and the mean gestational age at the time of injury was 21.4 weeks. Lower extremity fractures were the most common, with ankle fractures being predominant. Regional anesthesia was preferred whenever feasible. Fluoroscopy exposure was minimized in all cases. Fracture union was achieved in all patients. No anesthesia- or radiation-related fetal complications were observed. Conclusion: Surgically treated fractures during pregnancy can be managed safely with a multidisciplinary approach, appropriate anesthesia selection, and strict adherence to radiation safety protocols.