[A neonatal supracondylar humeral fracture resembling a plexus injury]

A supracondylar fracture of the distal humerus in the newborn is a rare injury that can occur during a traumatic partus. It can be difficult to make the correct diagnosis soon after birth.

A neonate, born by a short fundal delivery in an otherwise minimally traumatic partus had reduced movement in the lower left arm on the first day of life. Physical examination and conventional radiography did not reveal any other abnormalities, suggesting a brachial plexus injury. As the arm movement did not improve, two weeks after birth radiographic investigations were repeated and a supracondylar humeral fracture was diagnosed. After a period of immobilisation without a plaster cast, the function of the elbow was completely restored in this otherwise healthy child.

In neonates with a supracondylar humeral fracture clear clinical or radiological signs may be absent. According to the literature, ultrasonography is effective in revealing these fractures at an early stage. Generally, these fractures heal well without a plaster cast.