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Am J Perinatol 2002; 19(1): 017-022
DOI: 10.1055/s-2002-20169
ORIGINAL ARTICLE

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Neonatal Clavicular Fracture: Clinical Analysis of Incidence, Predisposing Factors, Diagnosis, and Outcome

Te-Yao Hsu1 , Fang-Chih Hung2 , Ying-Jen Lu1 , Chia-Yu Ou1 , Cherng-Jau Roan1 , Fu-Tsai Kung1 , Chan-Chao Changchien1 , Shiuh-Young Chang1
  • 1Departments of Obstetrics and Gynecology, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
  • 2Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Publication Date:
18 February 2002 (online)

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ABSTRACT

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.

KEYWORD

Neonatal - clavicular fracture - incidence - predisposing factors

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