The Upper Limbs

In children, the clavicle (collarbone) is one of the bones that is most susceptible to fracture. In most cases, immobilization is the preferred choice of treatment; only in exceptional cases does surgery prove necessary, and this is confined to cases where there is a simple fracture with exposure of the bone. Fractures in neonates may be caused by natural delivery, especially in macrosomic children weighing more than 4 kg, or by compression trauma of the shoulders in the course of dystocic delivery. In older children, the trauma most commonly responsible for fracture is a fall on the shoulder with direct trauma, or with an outstretched arm.