March 1991

Clavicular Fractures in Neonates

Author Affiliations

Department of Pediatrics
Department of Obstetrics/Gynecology Texas Tech University Health Sciences Center Regional Academic Health Center at Odessa Odessa, TX 79763

Am J Dis Child. 1991;145(3):251-252. doi:10.1001/archpedi.1991.02160030015009

Sir.—We read with interest the article by Joseph and Rosenfeld1 in the February 1990 issue of AJDC. We have noticed an increased occurrence of clavicular fractures in our institution during the last 6 months (12 [1.48%] of 812 newborns). We looked at different variables, including maternal age, parity, infant's weight, maternal diabetes, length of labor, oxytocin (Pitocin) induction, delivery methods, local anesthesia, episiotomy, delivery time, and delivering physician (house staff or attending staff) to find the common factor(s) in these infants.

The only common factor for seven of the affected infants was a shorter second stage of labor (mean, 11.4 minutes). In contrast to the authors' observation that only one of the 18 infants showed "classic" physical findings, we diagnosed fractures in 11 of 12 infants by the palpation of instability or crepitation over the fracture site. Roentgenography was used to confirm our clinical diagnosis. In one case,

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