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Fractured clavicle is an unavoidable event

R A Chez¹, S Carlan, S L Greenberg

¹Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.

American Journal of Obstetrics and Gynecology

|September 1, 1994

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Newborn clavicle fractures occur in 0.9% of vaginal births. Significant risk factors include gestational age, shoulder dystocia, and infant weight, but the injury appears unavoidable without long-term effects.

Area of Science:

Obstetrics and Gynecology
Neonatal Medicine
Pediatric Orthopedics

Background:

Clavicle fractures are a common birth injury.
Understanding incidence and risk factors is crucial for neonatal care.

Purpose of the Study:

Determine the incidence of newborn clavicle fractures.
Identify preventable risk factors for clavicle fractures.
Assess acute sequelae of clavicle fractures in neonates.

Main Methods:

Retrospective chart review of deliveries over an 8-month period.
Comparison of neonates with fractured clavicles to a control group.
Statistical analysis of maternal, labor, delivery, and newborn factors.

Main Results:

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Fractured clavicle incidence was 0.9% in vaginally delivered newborns; none occurred with cesarean delivery.
Significant risk factors identified: gestational age, shoulder dystocia, and newborn weight.
No association found between fractured clavicle and Apgar scores, cord blood pH, or neurologic examination.

Conclusions:

No specific, modifiable perinatal factors were identified to prevent clavicle fractures.
Clavicle fracture appears to be an unavoidable birth injury.
The injury is not associated with permanent sequelae and does not indicate a need for quality improvement.