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Newborn Clavicle Fractures: Does Clavicle Fracture Morphology Affect Brachial Plexus Injury?
Tuğrul Ergün1, Sevcan Sarikaya2
1Department of Orthopedics and Traumatology, Istinye University Liv Hospital, Istanbul.
Insights
Newborn clavicle fractures with spiral or oblique morphology are linked to a higher risk of brachial plexus injuries (BPIs). Early evaluation for BPI is recommended for infants with these fracture types.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Orthopedics
- Neonatal Care
Background:
- Newborn clavicle fractures and brachial plexus injuries (BPIs) are rare but serious perinatal complications.
- These injuries can significantly impact infant health and development.
- Understanding the relationship between fracture type and BPI is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the clinical association between clavicle fracture morphology and the occurrence of brachial plexus injuries in newborns.
- To identify specific fracture characteristics that may predict BPI risk.
- To inform clinical practice regarding the assessment of newborns with clavicle fractures.
Main Methods:
- Retrospective review of perinatal clavicle fractures diagnosed over a 6-year period.
- Analysis of fracture morphology (spiral, oblique, transverse) and localization (Allman types I and II).
- Statistical examination of the correlation between fracture morphology and the presence of BPI.
Main Results:
- The study included 55 newborns with clavicle fractures; 41.8% also had BPI.
- Spiral and oblique clavicle fracture morphologies showed a statistically significant correlation with BPI.
- Allman type I fractures were not associated with increased BPI risk.
Conclusions:
- This study is the first to link newborn clavicle fracture morphology to BPI.
- Spiral and oblique clavicle fractures in newborns warrant increased vigilance for potential BPI.
- Clinical evaluation for BPI should be considered in neonates presenting with these specific fracture morphologies.
Background:
Newborn clavicle fractures and brachial plexus injuries (BPIs) are rare but serious perinatal complications.
Methods:
The aim of this study was to examine the clinical relationship between the fracture morphology (spiral, oblique, transfer) of clavicle fractures that develop during delivery in newborns and BPI. We retrospectively reviewed all perinatal clavicle fractures diagnosed at our institution over 6 years.
Results:
The study included 55 newborn infants with perinatal clavicle fracture. Of these, 60% (n=33) were male. Right-side clavicle fractures were present in 56.4% (n=31) and shoulder dystocia was present in 58.2% (n=32) of the patients. Of the fracture localization of the patients, 85.5% (n=47) (Allman I) and 14.5% (n=8) (Allman II) were lateral. Allman type I fractures were not associated with increased BPI (P>0.05). It was observed that 40% (n=22) of the clavicle fractures were characterized by oblique morphology, 34.5% (n=19) of the fractures by spiral morphology, and 25.5% (n=14) of the fractures by transfer morphology. In all, 41.8% (n=23) of the sample also had BPI. Of the entire sample, 40% (n=22) most frequently showed oblique morphology fractures, whereas the patient group with BPI showed spiral morphology as the most common fracture, at a rate of 52.2% (n=10). After examining the relationship between fracture morphology and BPI, the study determined a statistically significant correlation between spiral and oblique morphology fractures and the development of BPI.
Conclusions:
To our knowledge, our study is the first to examine the relationship between newborn clavicle fracture morphology and BPI. We think that they should be evaluated for increased BPI risk in newborn patients that have clavicle fractures with spiral and oblique morphology.
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