Clavicular Fracture in Newborns: A Retrospective Five-Year Analysis

Background: Clavicular fracture is the most common birth bony injury in neonates. The goals of this retrospective study are to determine the incidence of clavicular fracture in our department during the past five years and to identify the associated perinatal factors. Methods: From December 1996 to November 2001, 128 deliveries with clavicular fracture were retrospectively reviewed. The clavicular fractures were diagnosed by physical examination and confirmed by radiological examination. Both maternal data and neonatal data were analyzed. Results: The incidence of neonatal clavicular fracture in our study was 0.8%. About 95% were diagnosed before the fourth day. Right side clavicle was more likely to be fractured than the left side (93/36). When compared to the control group, the fractured neonates were found to have a significantly heavier birth weight (3562 vs 3170 gm), more frequency of left occipitoanterior (LOA) presentation (63.3% vs. 44.5%), advanced maternal age (30.9 vs 28.6 years old), prolonged first and second stages of labor, and more frequency of instrumental deliveries (28/1). Conclusions: Neonatal clavicular fracture is a benign form of birth trauma with good prognosis. Possible perinatal factors associated with neonatal clavicular fracture are older maternal age, instrumental deliveries, and prolonged first and second stages of labor.