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Clavicular fractures in neonates
1Department of Pediatrics, Winthrop-University Hospital, Mineola, NY 11501.
American Journal of Diseases of Children (1960)
|February 1, 1990
Summary
Newborn clavicle fractures are more common than previously thought, with a 2.9% incidence found in this study. Many infant fractures present with few symptoms, necessitating follow-up examinations for accurate diagnosis.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Neonatal Care
Background:
- Reported incidence of newborn clavicle fractures varies widely (0.2%–3.5%).
- Clinical diagnosis during hospitalization often underestimates fracture occurrence.
Purpose of the Study:
- To determine the actual incidence of clavicle fractures in newborns.
- To identify reliable diagnostic signs and the necessity of follow-up examinations.
Main Methods:
- Screening of 626 consecutive vaginally delivered infants for clavicle fractures.
- Multiple examinations: twice during hospitalization and a follow-up at 2 weeks.
- Clinical assessment by a single physician (P.R.J.).
Main Results:
- Identified 18 fractured clavicles, yielding an incidence of 2.9% (18/626).
- Fractures were detected at discharge (10/18) and follow-up (7/18), with only 1 detected initially.
- Only 2 infants exhibited typical fracture symptoms; difficulty palpating clavicle margins was the most reliable sign.
- Mean birth weight was 3604g; no obstetric complications were noted.
Conclusions:
- Clinical diagnosis of newborn clavicle fractures during initial hospitalization is often insufficient.
- Most infant clavicle fractures are asymptomatic, requiring repeated examinations for accurate detection.
- Follow-up assessments are crucial for identifying the true incidence of neonatal clavicle fractures.