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Published on: April 11, 2012
Birth fracture of the clavicle
Andreas F Mavrogenis1, Evanthia A Mitsiokapa, Anastasios D Kanellopoulos
1First Department of Orthopaedics and Pediatric Orthopaedics, Athens University Medical School, Greece.
Insights
Birth fracture of the clavicle is common in vaginal births. Diagnosis can be challenging, especially for non-displaced fractures, often requiring imaging or repeated examinations.
Area of Science:
- Pediatrics
- Obstetrics
- Neonatal Care
Background:
- Birth fracture of the clavicle affects 0.4%–10% of vaginal births.
- Decreased arm movement is the most common symptom.
- A high index of suspicion is crucial for asymptomatic neonates.
Observation:
- Presents a case of a neonate with a right clavicle fracture diagnosed after callus formation.
- Highlights diagnostic challenges with non-displaced fractures.
- Emphasizes the need for vigilance in clinical assessment.
Findings:
- Non-displaced clavicular fractures may only become apparent later through callus formation.
- Radiography, ultrasonography, or multiple examinations aid diagnosis.
- Early detection is key for appropriate management.
Implications:
- Discusses associated factors and obstetrical care for clavicle fractures.
- Underscores the importance of thorough neonatal examination post-delivery.
- Informs clinical practice regarding the diagnosis and management of birth-related clavicle injuries.
Abstract:
Birth fracture of the clavicle occurs in approximately 0.4% to 10% of vaginal births. The most common symptom is decreased movement of the ipsilateral arm. A high index of suspicion is necessary in infants presenting without any symptoms. Although displaced clavicular fractures are relatively easily diagnosed clinically, nondisplaced fractures may be apparent only after callus formation, or if all neonates are subjected to radiography or ultrasonography, or multiple physical examinations by trained examiners. We present a case of an infant delivered with vaginal labor with a fracture of the right clavicle diagnosed after apparent callus formation and discuss the current evidence of associated factors and obstetrical care.
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