Fractured clavicle and Erb's palsy unrelated to birth trauma (original) (raw)
Related papers
Prospective study of incidence and predisposing factors for clavicular fracture in the newborn
Acta Obstetricia et Gynecologica Scandinavica, 1996
Ohjc,c./ii.<,. To deterniine the incidence of clavicular fractures. associated fetal and maternal risk t'actoi-s and i t \ connection M ith quality care control. .Sii/?jct 1 5 c i i~t / i r w t h o t l c. A total of 3030 newborns delivered vaginally were evaluated for cla-\.ictilar tracturea by three separate physicians. The study group included all newborns with iractiired cia\ iile. .A control group consisted of 52 newborns delivered vaginallly with no history ot firactures. Maternal records were evaluated for possible predisposing factors. Rc,sii/t\. Forty-six (I .5'7'r) newborns were found to have clavicular fractures. When compared 10 the control group. the! were found to have a higher birthweight (3710+352gm vs 3?35+405gni) an older maternal age (30.5+5 vs 27.7+6), a longer second stage of labor (34 min L 2. 3 min). higher rate of instrumental deliveries (1 3/46 vs 6/52) and shoulder dystocia i6/4h \ \ 1/52) Nearly 80% of newborns with clavicular fractures weighed less than 4000 gni. Midti\ xiate ;inal! si\ demonstrated two independent variables: birthweight over 3500 gin and Co/i,hi\ioii. Cia\ icular fractures are associated with higher birthweight, older maternal age, Iciiigei-\cconcI \rage of labor. instrumental deliveries and shoulder dystocia. However, in most caw\ [hi.\ injury cannot be predicted prior to delivery and thus cannot be an indicator of qual-it\ ccmtrol. nlat~rllal age :>29.
Acta Paediatrica, 2020
Fractures diagnosed among neonates are mainly birth-related. Other fractures diagnosed among neonates are mainly accidental. We set out to explore in a national register the current rate of birth-related and other fractures in the neonatal period, and their association with perinatal risk factors. Clavicle fractures are by far the predominant birth-related fractures, occurring as a result of the foetal anterior shoulder being compressed against the maternal symphysis pubis or when manoeuvres to diminish the chest circumference in shoulder dystocia is performed. Hospital studies report a clavicular fracture incidence of 0.2%-2.9%, diagnosed by clinical routine examination or due to symptoms, or incidentally found in postnatal X-rays or after discharge. Maternal
Fracture of the clavicle in the newborn following normal labor and delivery
International Journal of Gynecology & Obstetrics, 1998
Objective: Earlier works have associated neonatal clavicular fracture (0.2–3.5% of all deliveries) with a range of procedural, fetal and maternal risk factors; more recent studies, however, have failed to firmly identify any one or a combination of them. In the present work we sought to determine possible ante/intra-partum risk factors for this condition. Study design: Using a retrospective case-controlled approach,
Bilateral clavicle fracture in two newborn infants
Iranian journal of pediatrics, 2011
The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns. We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel. Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.
Neonatal Clavicle Fracture: A Review of Fourteen Cases in East Coast Peninsular Malaysia
IIUM Medical Journal Malaysia, 2020
Introduction: The purpose of this study is to identify the incidence of clavicle fractures in newborn associated with fetal, maternal and process of deliveries in Kuantan General Hospital from June 2012 until January 2014. This study is to determine epidemiological data of clavicle fractures, maternal and baby risk factors associated with clavicle fractures of newborn and its’ outcome. Methods: This is a prospective study. 13 patients were identified to fulfill the inclusion criteria of the study. The data of sociodemographic, associated fetal and maternal risk factors and the outcomes were recorded using proforma. The statistical data analysis was done using SPSS 12.0. Results: Out of 20,257 live births at our centre during the study period, 13 infants were diagnosed to have clavicle fractures, giving an incidence of 0.64 per 1000 live births. There were 5 (38.5%) left, 7 (53.8%) right and one (7.7%) bilateral fracture. All fractures located at the mid shaft of the clavicle and non...
Orthopaedic Birth Trauma: A Reflection of Current Perinatal Care
The Internet Journal of Gynecology and Obstetrics, 2007
Orthopaedic Birth Trauma (OBT) has not been evaluated in Nigeria. A three year prospective study of OBT at Wesley Guilds Hospital, Ilesa, Nigeria was embarked upon. A total of 84 patients had OBT (M / F, 1.2: 1) representing 61.3% of neonatal orthopaedic hospital admission and 70.6% of birth injuries. The OBT/ year was 28, 33.3% were recognized within 24 hours of birth and 2.4% mortality .The mean age was 8 +/-4.3 (range: 1-31) day. There were 50 cases of bone fractures (58.8%) as follows: clavicle-23, femur-12, humerus-11, radius & ulna-4. Brachial plexus injuries included Erb's palsy 31(36.5%) and Klumpke's palsy 2 (2.4%). Two cases were post-traumatic cerebral palsy and one skull fracture. The predisposing factor in each patient's case was identified. The treatment of choice was conservative rather than surgery. Out of the seventy-seven who were followed for up to 3 months, their outcome was uneventful. OBT incidence is high in Nigeria. OBT rate may be considered as an index of perinatal care. OBT rate can be a reflection of the health-care of the region and this may likely be improved with adequate health resource, trained personnel, improved socioeconomic standard and patient education.
Pediatric Radiology, 2009
Background Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. Objective We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed.
Prenatal Diagnosis and Management of Intrauterine Fracture
Obstetrical & Gynecological Survey, 2010
Intrauterine fracture is an extremely rare finding, but can occur as the result of maternal trauma, osteogenesis imperfecta (OI), or theoretically other metabolic/structural abnormalities. Increased clinical awareness of the diagnosis and optimal management of these cases can lead to more positive outcomes for the patient and her child. Blunt abdominal trauma late in gestation increases the risk of fetal skull fracture, while a known diagnosis of OI or other abnormalities leading to decreased fetal bone density creates concern for long bone fracture. Biochemical and genetic tests can aid in the prenatal diagnosis of OI, while ultrasound is the best overall imaging modality for identifying fetal fracture of any etiology. When fetal fracture is diagnosed radiologically, specific management is recommended to promote optimal outcomes for mother and fetus, with special consideration given to the mother with OI. With the exception of fetal fractures due to lethal conditions, cesarean delivery is recommended in most cases, especially when fetal or maternal well-being cannot be assured. When a patient presents with risk factors for intrauterine fracture, careful evaluation via thorough historytaking, ultrasonography of the entire fetal skeleton, and laboratory tests should be performed. Heightened awareness of intrauterine fracture allows better postpartum management, whether for simple fracture care or for long-term care of patients with OI or genetic/metabolic abnormalities. Target Audience: Obstetricians & Gynecologist, Family Physicians. Learning Objectives: After completion of this educational activity, the reader will be able to compare x-ray, ultrasound modalities and MRI and their utility in diagnosing fetal fracture. Formulate a differential diagnosis for fetal fracture. Propose a delivery plan for a patient whose fetus has a prenatally diagnosed fetal fracture. Unless otherwise noted below, each faculty's spouse/life partner (if any) has nothing to disclose. The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity. The Faculty and Staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity.
Perinatal Journal
Risk faktörü olmayan gebeliklerde brakiyal pleksus felci ve klavikula k›r›¤› olgular›nda yenido¤anda antropometrik farkl›l›klar Amaç: Omuz distosisi aç›s›ndan düflük risk tafl›yan olgularda brakiyal pleksus felci, klavikula k›r›¤› ve omuz/humerus k›r›¤› komplikas-yonlar›n› yaflayan yenido¤anlar›n antropometrik verilerinden yararlanarak antenatal de¤erlendirmeye yönelik öngörü oluflturmak. Yöntem: Distosik do¤uma neden olabilecek fetal makrozomi, maternal diyabet, maternal obezite ve gebelikte afl›r› kilo al›m›, omuz distosisi öyküsü, do¤um indüksiyonu, epidural anestezi gibi risk faktörleri d›flland›ktan sonra hastane veri taban›ndan retrospektif olarak ç›kar›lan do¤um komplikasyonu olgular›, ayn› obstetrik ve demografik özellikleri tafl›yan, ancak do¤um travmas› yaflamayan, ayn› tart› ve cinsiyette yenido¤an verileri ile birebir efllefltirildi. Bulgular: 185 yenido¤an komplikasyonu gözlendi; bunlar›n 149 tanesi klavikula k›r›¤›, 8 tanesi omuz ve humerus k›r›¤›, 28 tanesi de brakiyal pleksus felci olarak s›n›fland›r›ld›. Do¤um komplikasyonu yaflanan olgularda do¤umun 2. evresinin anlaml› flekilde daha uzun oldu¤u görüldü (p=0.01; 22.41±6.98 dakikaya karfl›l›k 24.23±6.43 dakika). Omuz distosisi, komplikasyonlar›n yafland›¤› çal›flma grubunda daha s›k gözlendi (p=0.0001; s›kl›¤› %32.97'ye karfl›l›k %2.7). Antropometrik ölçümler aç›s›ndan gö¤üs çevresi / bafl çevresi oran-lar›n›n ROC çal›flmas› anlaml› saptand›, oran›n 0.97'den büyük ol-mas› durumunda (AUC=0.903; sensitivite %77.84, spesifisite %89.73, PPD %88.3, NPD %80.2, LR 7.58) omuz distosisi ve komplikasyonlar› öngörebilece¤i görüldü. Komplikasyonlar›n 4000 gram›n üstündeki olgularda anlaml› olarak artmaya bafllad›¤› saptan-d› (p=0.029). Sonuç: Do¤um kanal› içinde omuzlar ve uzant›lar› travmaya aç›k-t›r. ‹leri sürdü¤ümüz hipotezde neonatal antropometrik veriler komplikasyonlar ile anlaml› flekilde korele bulunmufltur. Bir öngörüde bulunmak için, antenatal dönem ve özellikle de eylem s›ras›nda fetal bafl ölçümlerinin yan› s›ra ayr›ca bisakromiyal çap ve gö¤üs çevresi ölçümleri yard›mc› olabilir.