Birth fracture of the clavicle
Updates to Article Attributes
A birth fracture of the clavicle occurs in around 0.5-1% of vaginal deliveries and is the most frequent site of birth-related fracture. They are most commonly seen following normal uncomplicated births but there is recognised increased incidence with high birth weight babies, forceps delivery and shoulder dystocia.
Clinical presentation
Paucity of movements of the affected upper limb (pseudoparalysis) is the most common indicator of injury. Examination may reveal crepitus, palpable irregularity and sternocleidomastoid spasm.
Radiographic features
Fracture is most often of the midshaft. The fracture ends are usually not horizontally distracted, as opposed to the appearance of clavicle pseudoarthrosis. Small amount of comminution can occur. Evidence of healing callous is often apparent. Ultrasound can be used as an alternative to radiographs with good sensitivity.
Treatment and prognosis
Birth fractures of the clavicle usually heal in 7 to 10 days without any residual problems. Less commonly there may be accompanying injuries to the brachial plexus, spine or humerus.
Differential diagnosis
-
congenital pseudoarthrosis of the clavicle
- absent portion of shaft means the pseudo-fracture ends are horizontally distracted
- sclerotic margins of the pseudo-fracture ends
- normal arm movement (no pseudoparalysis)
- no healing callous seen
-
cleidocranial dysplasia
- hypoplasia or total absence of clavicle
- part of generalized skeletal dysplasia
-<p>A <strong>birth fracture of the clavicle</strong> occurs in around 0.5-1% of vaginal deliveries and is the most frequent site of <a title="birth-related fracture" href="/articles/birth-related-fracture">birth-related fracture</a>. They are most commonly seen following normal uncomplicated births but there is recognised increased incidence with high birth weight babies, <a title="forceps delivery" href="/articles/forceps-delivery">forceps delivery</a> and <a title="shoulder dystocia" href="/articles/shoulder-dystocia">shoulder dystocia</a>. </p><h4>Clinical presentation</h4><p>Paucity of movements of the affected upper limb (pseudoparalysis) is the most common indicator of injury. Examination may reveal crepitus, palpable irregularity and sternocleidomastoid spasm.</p><h4>Radiographic features</h4><p>Fracture is most often of the midshaft. The fracture ends are usually not horizontally distracted, as opposed to the appearance of clavicle pseudoarthrosis. Small amount of comminution can occur. Evidence of healing callous is often apparent. Ultrasound can be used as an alternative to radiographs with good sensitivity.</p><h4>Treatment and prognosis</h4><p>Birth fractures of the clavicle usually heal in 7 to 10 days without any residual problems. Less commonly there may be accompanying injuries to the brachial plexus, spine or humerus.</p><h4>Differential diagnosis</h4><ul>- +<p>A <strong>birth fracture of the clavicle</strong> occurs in around 0.5-1% of vaginal deliveries and is the most frequent site of <a href="/articles/birth-related-fracture">birth-related fracture</a>. They are most commonly seen following normal uncomplicated births but there is recognised increased incidence with high birth weight babies, <a href="/articles/forceps-delivery">forceps delivery</a> and <a href="/articles/shoulder-dystocia">shoulder dystocia</a>. </p><h4>Clinical presentation</h4><p>Paucity of movements of the affected upper limb (pseudoparalysis) is the most common indicator of injury. Examination may reveal crepitus, palpable irregularity and sternocleidomastoid spasm.</p><h4>Radiographic features</h4><p>Fracture is most often of the midshaft. The fracture ends are usually not horizontally distracted, as opposed to the appearance of clavicle pseudoarthrosis. Small amount of comminution can occur. Evidence of healing callous is often apparent. Ultrasound can be used as an alternative to radiographs with good sensitivity.</p><h4>Treatment and prognosis</h4><p>Birth fractures of the clavicle usually heal in 7 to 10 days without any residual problems. Less commonly there may be accompanying injuries to the brachial plexus, spine or humerus.</p><h4>Differential diagnosis</h4><ul>
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