Background and Aims
  Fractures in prematurity may result from osteopenia. Five cases of long bone fractures were reported to find the clinical features and risk factors of osteopenic long bone fractures.

Method
  Five premature neonates with birth weight < 1500 gm, born at Taichung Veterans General Hospital between years of 2009 to 2014 with long bone fractures, were retrospectively reviewed. All patients was verified by X-ray to be osteopenic (Figure 2). All eligible neonates were examined for serum parameters, duration of parenteral nutrition, concomitant medication and co-morbidities.

Results
  The median (range) gestational age was 26 weeks (24-27) and the median (range) birth weight was 658 gm (500-750). The median (range) chronological age when fracture occurred was 79 days (65-110). Two of five neonates had fractures greater than 1 site. The initial presentation of all patients was painful swelling of affected site with irritable cry. The percentage of diuretics use, bronchopulmonary dysplasia, necrotizing enterocolitis, cholestasis, hypocalcemia, hypophosphatemia, sepsis and mortality were illustrated in figure 1. The median (range) alkaline phosphatase level measured was 823 IU/L (611-1488) and the median (range) duration of total parental nutrition was 92 (69-167) days.

Conclusion
  Very low birth weight infants (VLBWI) with risk factors for osteopenic fractures should be monitored for osteopenia and encourage early enteral feeding with adequately nutritional supplement to prevent such complication.

7th Congress of the European Academy of Paediatric Societies