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Clavicular Fractures in Neonates

Clavicular Fractures in Neonates Abstract • We evaluated the wide variation in the reported incidence of fractured clavicles (0.2% to 3.5%) in newborns by screening 626 consecutive infants delivered vaginally for fractures. One of us (P.R.J.) evaluated all infants, twice during the initial hospital stay and 2 weeks later. Eighteen fractured clavicles were identified for a frequency of 2.9% (18/626). One fracture was discovered on the first hospital examination, 10 on discharge, and 7 at follow-up. Only 2 patients had symptoms usually associated with fractured clavicles. The most reliable clinical sign for inhospital diagnosis was difficulty in feeling the margins of the affected clavicle when compared with the normal clavicle. The mean birth weight of the infants was 3604 g (range, 3000 to 4930 g), and no obstetric complications occurred. The reported frequency of fractures diagnosed clinically during hospitalization significantly underestimates their occurrence. Most newborn infants with fractures have no symptoms and minimal physical findings during the first days of life, making repeated examination necessary. (AJDC. 1990;144:165-167) References 1. Glasgow LA, Overall JC Jr. The fetus and the neonatal infant . In: Ved Behrman RE, Vaughan VC III, eds. Nelson Textbook of Pediatrics . Philadelphia, Pa: WB Saunders Co; 1983:360-361. 2. Fraser FC. Miscellaneous disorders of the musculoskeletal system . In: Avery MA, Taeusch HW, eds. Schaffer's Diseases of the Newborn . Philadelphia, Pa: WB Saunders Co; 1984:840-841. 3. Mangurten H. Birth injuries . In: Fanaroff AA, Martin RJ, eds. Neonatal-Perinatal Medicine . St Louis, Mo: CV Mosby Co; 1987:328. 4. Farkas R, Levine S. X-ray incidence of fractured clavicle in vertex presentation . Am J Obstet Gynecol . 1950;59:204-206. 5. Enzler A. Die Claviculafraktur als Geburtsverletzung des Neugeborenen . Schweiz Med Wochenschr . 1950;80:1280-1283. 6. Madsen ET. Fractures of the extremities in the newborn . Acta Obstet Gynecol Scand . 1955; 34:41-74.Crossref 7. Muus N. Klavikularfrakturen Neugeborener bei Geburt in Schadellage . Zentralbl Gynakol . 1903;23:689-693. 8. Troitzkaja TW. Cited by: Hukewytsch B. Schlusselbeinbruche der Neugeborenen bei Spontangeburten in Schadellage . Monatsschr Geburtsh Gynaecol . 1929;83:25-34. 9. Hukewytsch B. Schlusselbeinbruche der Neugeborenen bei Spontangeburten in Schadellage . Monatsschr Geburtsh Gynaecol . 1929;83:25-34. 10. Hedberg GT. Clavicle fracture of the newborn in vertex presentation . Acta Obstet Gynecol Scand . 1946;26:321-328.Crossref 11. Nasso S, Verga A. La frattura della clavicola nel neonato . Minerva Pediatr . 1954;15:593-597. 12. Rubin A. Birth injuries: incidence, mechanisms, and end results . Obstet Gynecol . 1964; 23:218-221. 13. Levine MG, Holroyde J, Woods JR, Siddiqi TA, Scott M, Miodovnik M. Birth trauma: incidence and predisposing factors . Obstet Gynecol . 1984; 63:792-795. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1990.02150260043024
Publisher site
See Article on Publisher Site

Abstract

Abstract • We evaluated the wide variation in the reported incidence of fractured clavicles (0.2% to 3.5%) in newborns by screening 626 consecutive infants delivered vaginally for fractures. One of us (P.R.J.) evaluated all infants, twice during the initial hospital stay and 2 weeks later. Eighteen fractured clavicles were identified for a frequency of 2.9% (18/626). One fracture was discovered on the first hospital examination, 10 on discharge, and 7 at follow-up. Only 2 patients had symptoms usually associated with fractured clavicles. The most reliable clinical sign for inhospital diagnosis was difficulty in feeling the margins of the affected clavicle when compared with the normal clavicle. The mean birth weight of the infants was 3604 g (range, 3000 to 4930 g), and no obstetric complications occurred. The reported frequency of fractures diagnosed clinically during hospitalization significantly underestimates their occurrence. Most newborn infants with fractures have no symptoms and minimal physical findings during the first days of life, making repeated examination necessary. (AJDC. 1990;144:165-167) References 1. Glasgow LA, Overall JC Jr. The fetus and the neonatal infant . In: Ved Behrman RE, Vaughan VC III, eds. Nelson Textbook of Pediatrics . Philadelphia, Pa: WB Saunders Co; 1983:360-361. 2. Fraser FC. Miscellaneous disorders of the musculoskeletal system . In: Avery MA, Taeusch HW, eds. Schaffer's Diseases of the Newborn . Philadelphia, Pa: WB Saunders Co; 1984:840-841. 3. Mangurten H. Birth injuries . In: Fanaroff AA, Martin RJ, eds. Neonatal-Perinatal Medicine . St Louis, Mo: CV Mosby Co; 1987:328. 4. Farkas R, Levine S. X-ray incidence of fractured clavicle in vertex presentation . Am J Obstet Gynecol . 1950;59:204-206. 5. Enzler A. Die Claviculafraktur als Geburtsverletzung des Neugeborenen . Schweiz Med Wochenschr . 1950;80:1280-1283. 6. Madsen ET. Fractures of the extremities in the newborn . Acta Obstet Gynecol Scand . 1955; 34:41-74.Crossref 7. Muus N. Klavikularfrakturen Neugeborener bei Geburt in Schadellage . Zentralbl Gynakol . 1903;23:689-693. 8. Troitzkaja TW. Cited by: Hukewytsch B. Schlusselbeinbruche der Neugeborenen bei Spontangeburten in Schadellage . Monatsschr Geburtsh Gynaecol . 1929;83:25-34. 9. Hukewytsch B. Schlusselbeinbruche der Neugeborenen bei Spontangeburten in Schadellage . Monatsschr Geburtsh Gynaecol . 1929;83:25-34. 10. Hedberg GT. Clavicle fracture of the newborn in vertex presentation . Acta Obstet Gynecol Scand . 1946;26:321-328.Crossref 11. Nasso S, Verga A. La frattura della clavicola nel neonato . Minerva Pediatr . 1954;15:593-597. 12. Rubin A. Birth injuries: incidence, mechanisms, and end results . Obstet Gynecol . 1964; 23:218-221. 13. Levine MG, Holroyde J, Woods JR, Siddiqi TA, Scott M, Miodovnik M. Birth trauma: incidence and predisposing factors . Obstet Gynecol . 1984; 63:792-795.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1990

References