title: Neonatal clavicular fracture: recent 10 year study.
abstract: BACKGROUND
  The clavicle is the bone most frequently fractured during the delivery process.
  
  
  METHODS
  A retrospective review was performed of all births with clavicular fractures from January 2003 to December 2012. Risk factors for fracture were determined and then compared to the control group. The data were compared and analyzed with previous studies.
  
  
  RESULTS
  Three hundred and nineteen cases of clavicular fracture (0.41% of total live births, n = 77 543) were identified. Prior to discharge, 275 cases (86.2%) were detected, and 44 cases (13.8%) were not detected until after discharge. Physical examination identified 144 cases (45.1%), while 175 cases (54.9%) were identified on chest X-ray incidentally. All babies with fracture, including five (1.6%) with brachial plexus palsy, recovered without treatment. Vacuum delivery was associated with a significantly higher incidence of clavicular fracture, as were mothers of advanced age with relatively shorter height. High birthweight, low head to chest circumference ratio and low Apgar score were other variables also significantly associated with clavicular fracture. On logistic regression analysis vacuum delivery and birthweight were significant risk factors. When analyzing and comparing findings from previous studies, only birthweight was identified as common to the risk factors affecting clavicular fracture.
  
  
  CONCLUSIONS
  Major risk factors for clavicular fracture were vacuum delivery and birthweight. Considering the previous studies together, neonatal clavicular fracture appears to be a transient event without sequelae and most probably not preventable during birth.
authors.affiliation: Department of Pediatrics, Cheil General Hospital and Women's Health Care Center, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Eun Sub
authors.initials: ES
authors.lastname: Ahn
authors.forename: Moon Sun
authors.initials: MS
authors.lastname: Jung
authors.forename: Yeon Kyung
authors.initials: YK
authors.lastname: Lee
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Ko
authors.forename: Son Moon
authors.initials: SM
authors.lastname: Shin
authors.forename: Myung Hoon
authors.initials: MH
authors.lastname: Hahn
mesh_terms: D001720:Birth Injuries / Q000150:complications* / Q000453:epidemiology; D002968:Clavicle / Q000293:injuries*; D005260:Female; D005544:Forecasting; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects*
keywords: clavicular fracture; diagnosis; incidence; prognosis; risk factor