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Newborn clavicle fractures
M T McBride1, W L Hennrikus, T S Mologne
1Department of Orthopedic Surgery and Clinical Investigation, Naval Hospital, San Diego, Calif., USA.
Insights
Clavicle fractures affect 1 in 213 newborns, often linked to difficult vaginal births. These fractures can sometimes occur alongside brachial plexus palsy, highlighting the need for careful delivery management.
Area of Science:
- Neonatal care
- Orthopedic surgery
- Obstetrics
Background:
- Neonatal clavicle fractures are common birth injuries.
- Understanding their prevalence and associated risk factors is crucial for prevention and management.
Purpose of the Study:
- To determine the prevalence of clavicle fractures in newborns.
- To identify risk factors associated with these fractures.
- To assess the co-occurrence of clavicle fractures and brachial plexus palsy.
Main Methods:
- A prospective screening program involving 9106 newborns was conducted.
- Data on birth weight, delivery method, and infant sex were collected.
- Infants diagnosed with clavicle fractures were monitored for associated injuries.
Main Results:
- The prevalence of clavicle fractures was 0.5% (1 in 213 live births).
- Fractures were evenly distributed between sexes and sides.
- Risk factors included large birth weight, shoulder dystocia, assisted delivery, and prolonged gestation.
- One in 11 infants with clavicle fracture also had brachial plexus palsy.
Conclusions:
- Neonatal clavicle fractures are a significant birth complication.
- Specific delivery circumstances and infant characteristics increase fracture risk.
- The association with brachial plexus palsy warrants further investigation and emphasizes the importance of vigilant obstetric care.
Abstract:
A prospective screening program of 9106 newborns identified 43 infants with clavicle fractures for a prevalence of 1 fracture in every 213 live births (0.5%). The fractures were equally distributed by right and left side involvement, and male and female sex. All fractures occurred during vaginal deliveries. None were breech presentation. Risk factors for fracture included large birth-weight, shoulder dystocia, mechanically assisted delivery, and prolonged gestational age. One in 11 newborns with a clavicle fracture also had a brachial plexus palsy.