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Clavicle Fracture in Newborns: Causes and Treatments

Clavicle fractures, also known as collarbone fractures, are a common injury in newborns. The clavicle is the bone that connects the shoulder to the breastbone, and it is one of the most frequently fractured bones in the body. In newborns, clavicle fractures often occur during the birthing process, particularly during difficult deliveries. While these fractures can be painful for the newborn, they typically heal well with proper treatment and care. This article will explore the causes and treatments of clavicle fractures in newborns, providing valuable insights based on research and medical expertise.

Causes of Clavicle Fracture in Newborns

Clavicle fractures in newborns are primarily caused by the birthing process. During a difficult delivery, the baby’s shoulder may become stuck behind the mother’s pelvic bone, resulting in excessive pressure on the clavicle. This pressure can cause the bone to fracture or break. Factors that increase the risk of clavicle fractures in newborns include:

  • Large birth weight: Babies with a higher birth weight are more likely to experience clavicle fractures during delivery.
  • Prolonged labor: Long and difficult labors can increase the likelihood of clavicle fractures in newborns.
  • Shoulder dystocia: This occurs when the baby’s shoulder becomes stuck behind the mother’s pelvic bone, putting significant pressure on the clavicle.
  • Assisted delivery: The use of forceps or vacuum extraction during delivery can increase the risk of clavicle fractures in newborns.

It is important to note that clavicle fractures in newborns are typically accidental and not a result of negligence or improper medical care.

Symptoms and Diagnosis

Identifying a clavicle fracture in a newborn can be challenging, as they are unable to communicate their pain. However, there are several common symptoms that may indicate a clavicle fracture:

  • Visible swelling or bruising around the collarbone area
  • Refusal to move the arm on the affected side
  • Crying or signs of distress when the affected arm is touched or moved
  • A lump or bump over the fractured area

If a clavicle fracture is suspected, a healthcare provider will perform a physical examination to assess the baby’s range of motion and look for signs of injury. In some cases, an X-ray may be ordered to confirm the diagnosis and determine the severity of the fracture.

Treatment Options

The majority of clavicle fractures in newborns can be managed without surgery. The main goal of treatment is to ensure proper healing and alleviate any discomfort or pain. The following treatment options are commonly used:

  • Immobilization: The affected arm may be immobilized using a splint or a sling to prevent movement and promote healing. This can help reduce pain and prevent further injury.
  • Pain management: Over-the-counter pain relievers, such as acetaminophen, may be recommended to alleviate any discomfort or pain associated with the fracture.
  • Gentle exercises: Once the initial pain and swelling have subsided, gentle range-of-motion exercises may be prescribed to prevent stiffness and promote healing.
  • Follow-up care: Regular follow-up appointments with a healthcare provider are essential to monitor the healing process and ensure proper alignment of the clavicle.

In rare cases where the fracture is severe or does not heal properly, surgery may be required. Surgical intervention may involve realigning the fractured bone and securing it with pins, plates, or screws. However, surgery is typically reserved for complex fractures or cases where non-surgical treatment options have been unsuccessful.

Complications and Long-Term Outlook

Clavicle fractures in newborns generally have a good prognosis, with most infants experiencing complete healing within a few weeks to a couple of months. However, there can be some potential complications and long-term effects associated with these fractures:

  • Malunion: In some cases, the fractured clavicle may heal in an abnormal position, resulting in a slight deformity. However, this is usually not a cause for concern, as it does not typically affect the baby’s overall function or range of motion.
  • Infection: Although rare, there is a small risk of infection at the site of the fracture. It is important to monitor the area for any signs of infection, such as increased redness, swelling, or discharge.
  • Delayed healing: Some clavicle fractures may take longer to heal, especially if the fracture is severe or if there are underlying medical conditions that affect bone healing.

It is crucial for parents to follow the healthcare provider’s instructions for care and attend all follow-up appointments to ensure proper healing and monitor for any potential complications.

Prevention and Risk Reduction

While it may not be possible to prevent all clavicle fractures in newborns, there are certain measures that can help reduce the risk:

  • Proper prenatal care: Regular prenatal check-ups and monitoring can help identify any potential risk factors or complications that may increase the likelihood of a difficult delivery.
  • Delivery techniques: Healthcare providers can use specific delivery techniques, such as the McRoberts maneuver or the Woods’ screw maneuver, to help prevent shoulder dystocia and reduce the risk of clavicle fractures.
  • Assisted delivery: In cases where a difficult delivery is anticipated, healthcare providers may opt for an assisted delivery using forceps or vacuum extraction. However, it is important to weigh the potential benefits against the risks associated with these interventions.

It is essential for healthcare providers to carefully assess each individual case and make informed decisions to ensure the safety and well-being of both the mother and the baby.

Summary

Clavicle fractures in newborns are a common injury that often occurs during the birthing process. These fractures are primarily caused by the pressure exerted on the clavicle during a difficult delivery. While they can be painful for the newborn, clavicle fractures generally heal well with proper treatment and care. Treatment options include immobilization, pain management, gentle exercises, and regular follow-up care. In rare cases, surgery may be required. Complications and long-term effects are rare but can include malunion, infection, and delayed healing. Taking preventive measures, such as proper prenatal care and delivery techniques, can help reduce the risk of clavicle fractures in newborns. By understanding the causes and treatments of clavicle fractures in newborns, parents and healthcare providers can ensure the best possible outcomes for these young patients.

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