Breaking it to them gently: fractured clavicle in the newborn
Siba Prosad Paul1, Paul Anthony Heaton1, Karishma Patel1
1Yeovil District Hospital.
Insights
Clavicular fractures are common birth injuries in newborns, often missed at discharge. Healing typically occurs without intervention, but documentation is crucial for medico-legal reasons.
Area of Science:
- Neonatal care
- Pediatric orthopedics
- Obstetrics
Background:
- Birth injuries, particularly clavicular fractures, are prevalent in newborns.
- The incidence of clavicle fractures ranges from 0.35% to 2.9% of births.
- Up to 40% of these fractures go undetected before hospital discharge.
Observation:
- Clinical suspicion arises from shoulder dystocia history or palpation findings like crepitus.
- Imaging studies are essential for confirming a fractured clavicle.
- A case of newborn clavicular fracture linked to shoulder dystocia after vaginal birth is presented.
Findings:
- Clavicular fractures are the most common bony injury in neonates.
- Early detection is often missed, leading to delayed diagnosis.
- Healing is generally uncomplicated and without long-term deformity.
Implications:
- Accurate diagnosis and parental reassurance are vital.
- Thorough documentation is important for medico-legal considerations.
- Understanding the association with shoulder dystocia aids in risk assessment.
Abstract:
Birth injuries are frequently seen in newborn infants. Clavicular fractures are the most commonly encountered bony injuries seen in clinical practice. The incidence of clavicle fracture ranges from 0.35 per cent to 2.9 per cent of births and remains undetected at the time of discharge from hospital in up to 40 per cent of cases. Clinical suspicion of fractured clavicle may be raised from history (shoulder dystocia) or clinical examination (spongy feeling or crepitus on palpation). This should be confirmed with imaging studies. Parents should have the diagnosis explained and be reassured that healing without residual deformity will occur without any medical intervention. Careful documentation of any confirmed clavicle fracture is important from medico-legal aspects. We present the case of a newborn clavicular fracture associated with shoulder dystocia, following a vaginal birth,.
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