[The clavicular fracture--a questionable achievement in modern obstetrics]

The increase in fractures of the clavicle as a birth trauma at the Innsbruck University Gynecological Clinic in the last decades, which was substantial in contrast to the improvement in perinatal mortality and morbidity, indicated an analysis of the reason. With the exception of the high average birth weights, the causal factors crystallised out, in the broadest sense, as being related to the control and direction of labour. The anticipated fetal distress condition at the end of the expulsion period proved to be of primary importance. This resulted in a too early and traumatic delivery, which could not be justified by the good navel arterial pH and Apgar values. By observing certain procedures, it was possible to reduce the frequency of fractures of the clavicle in spontaneous births from 2 to 1.25% maintaining the same fetal outcome.