Fractured clavicle in the newborn

Answer 1

Definition

A fractured clavicle in the newborn is a broken collar bone in a baby that was just delivered.

Alternative Names

Fractured collar bone - newborn

Causes, incidence, and risk factors

A fracture of a newborn's collar bone (clavicle) can occur during a difficult vaginal delivery. It is fairly common during difficult births.

Symptoms

The baby will not move the painful, injured arm. Instead, the baby will hold it still against the side of the body. Lifting the baby under the arms causes the child pain. Sometimes the fracture can be felt with the fingers, but usually the problem cannot be seen or felt.

Within a few weeks, a hard lump may develop where the bone is healing. This lump may be the only sign that the newborn had a broken collar bone.

Signs and tests

A chest x-ray will show whether or not there is a broken bone.

An infant's refusal to move an arm may also be due to partial dislocation of the elbow (nursemaid's elbow), nerve damage (Erb palsy), broken humerus (upper arm bone), or other causes.

Treatment

Generally, there is no treatment other than lifting the child gently to prevent discomfort. Occasionally, the arm on the affected side may be immobilized, most often by simply pinning the sleeve to the clothes.

Expectations (prognosis)

Full recovery occurs without treatment.

Complications

There are usually no complications. Later in life, due to the excellent healing potential of infants, it may be impossible (even by x-ray) to tell that a fracture occurred.

Calling your health care provider

Call for an appointment with your health care provider if your baby acts uncomfortable when you lift him or her.

References

Daya M, Nakamura Y. Shoulder. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 50.

Carlo WA. Delivery room emergencies. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 94.

Reviewed By

Review Date: 08/13/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.