Clavice Fracture

Clavicle is the bone most commonly fractured during labor and delivery. Although difficult delivery of the shoulder, or extended arms in breech deliveries increase the chances of a clavicle fractures, they can be present even with a history of a normal delivery.

Diagnosis: In addition to delivery history the following features may point towards the diagnosis:
-Decrease/assymetric movement of the limbs. (This may be evident by presence of an assymetric Moro's reflex)
-Palpable crepitus or bony irregularity early on
-A large callus forms quickly and is generally palpable by age 1 week.

Prognosis is excellent. Treatment, if any, is limited to immobilization of the arm and shoulder on the affected side (simply pinning the sleeve to the side of the infant's shirt does the trick). Figure of 8 bandages are no longer used.

Differential diagnosis: Congenital pseudoarthrosis of the clavicle

This condition presents as a palpable lump in the center of the clavicle that does not change or heal with any amount of time. Its cause is unknown. The condition is more common on the right side and generally does not lead to any functional impairment. Surgery is rarely indicated.

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