Birth fractures of the clavicle occur in 0.5-1% of vaginal deliveries and are the most frequent 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.
Paucity of movements of the affected upper limb (pseudoparalysis) is the most common indicator of injury. An examination may reveal crepitus, palpable irregularity and sternocleidomastoid spasm.
Fracture is most often of the midshaft. The fracture ends are usually not horizontally distracted, as opposed to the appearance of clavicle pseudoarthrosis. A 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.
congenital pseudoarthrosis of the clavicle
- absent portion of the 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
- hypoplasia or total absence of clavicle
- part of generalised skeletal dysplasia
- 1. Pediatric Cardiac Birth Trauma by Nirupama Laroia from emedicine.com. Pediatric Cardiac Birth Trauma
- 2. http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijos/vol5n1/disorder.xml