Letters to the Editor
Clavicle Fractures During Birth
Am Fam Physician. 2008 Sep 15;78(6):697.
Original Article: Clavicle Fractures
Issue Date: January 1, 2008
Available at: http://www.aafp.org/afp/20080101/65.html
to the editor: The article on clavicle fractures by Drs. Pecci and Kreher is interesting. I would like to add an important cause of clavicle fracture in newborns that was not mentioned in the article. Clavicle fractures sometimes occur during childbirth, especially during a difficult cephalic vaginal delivery or following a breech delivery.1,2 These fractures still occur in developing countries, where such deliveries are more common. The child usually presents up to a few weeks after delivery with a palpable swelling on the mid-shaft location of the clavicle.3 There are usually no other symptoms. Plain radiography of the clavicle confirms the diagnosis with callous formation visible in the second or third week after birth.
1. Kaplan B, Rabinerson D, Avrech OM, Carmi N, Steinberg DM, Merlob P. Fracture of the clavicle in the newborn following normal labor and delivery. Int J Gynaecol Obstet. 1998;63(1):15–20.
2. Turnpenny PD, Nimmo A. Fractured clavicle of the newborn in a population with a high prevalence of grand-multiparity: analysis of 78 consecutive cases. Br J Obstet Gynaecol. 1993;100(4):338–341.
3. Reiners CH, Souid AK, Oliphant M, Newman N. Palpable spongy mass over the clavicle, an underutilized sign of clavicular fracture in the newborn. Clin Pediatr (Phila). 2000;39(12):695–698.
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