Neonatal clavicular fracture: clinical analysis of incidence, predisposing factors, diagnosis, and outcome.
The objective of this study is to identify maternal, perinatal, and fetal risk factors for clavicular fracture in a single institution. We performed a prospective study of all deliveries during a 14-month period to identify confirmed cases of neonatal clavicular fracture. The control group consisted of the deliveries immediately preceding and following the index cases. Fifty-three cases of clavicular fracture were identified among the 4789 deliveries from October 1995 through November 1996 for an incidence of 1.11%. Three neonates in the clavicular fracture group were delivered through cesarean section. Neonates with fracture were significantly heavier at birth than those without (3564 vs. 3283 g, p <0.001), and had a lower mean head-to-abdominal circumference ratio (0.93 vs. 1.08, p <0.001), history of giving birth to a macrosomia (21 vs. 4%, p <0.05). The anterior shoulder was the predominant site of fracture (30/53). Fracture was detected mostly during the first 3 days of neonatal life (46/53). The outcome was benign, with complete recovery in all cases and no associated neurological sequelae. Neonatal clavicular fracture tended to be associated with neonatal somatometric characteristics and difficult deliveries. Considering the benign nature of this birth trauma, more invasive intrapartum management to lower its incidence is not advised.
Hsu
Te-Yao
TY
Department of Obstetrics and Gynecology, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan.
Hung
Fang-Chih
FC
Lu
Ying-Jen
YJ
Ou
Chia-Yu
CY
Roan
Cherng-Jau
CJ
Kung
Fu-Tsai
FT
Changchien
Chan-Chao
CC
Chang
Shiuh-Young
SY
D001720:Birth Injuries / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D001724:Birth Weight; D002968:Clavicle / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors