The clavicle is the most frequently fractured bone in the full-term newborn during vaginal delivery. In the new-born, the breaking force may arise from compression of the shoulders during a difficult delivery at birth. An asymptomatic fracture in
the
neonate may be ignored. It will unite without external immobilization and any malalignment will correct itself with growth.
The typical clinical sings of the clavicle fractures are diminished movement of the affected side arm. On palpation, there is local swelling, tenderness, crecipitation over the fracture site. Fracture in the middle third of the clavicle will be
clearly
depicted in the anterior posterior radiogram. To demonstrate fractures of the medial and lateral end of the clavicle, however, special oblique, lateral. Or lordotic 40-degee tilt views may be required.
This study was analized 6,158 live births. Who were delivered at the Soonchunhyang nuiversity hospital from January 1991 to August 1993.
@ES The results were as follows:
@EN 1. The incidence of clavicle fracture was 0.28%(17 cases), and 16 cases were in normal spontaneous vaginal delivery, only one case was occured in cesarean section.
2. The incidence of clavicle fracture by presentation was following; 15 cases of vertex presentation and 1 case of breech presentation in the vaginal delivery, 1 case of vertex presentation incesarean section.
3. The incidence of site(right or left) of clavicle fracture was left site in 41.2%(7 cases), right site in 58.2%(10 cases), but there was no statistical difference between incidence of fracture site(right or left).
4. The incident site of clavicle fracture was at mid 1/3 in 58.8%(10 cases), inner 1/3 in 29.4%(5 cases), outer 1/3 in 11.8%(2 cases).
5. During vaginal delivery, the correlation between the incidence of clavicle fracture and body weight are as follows: below 300gm in 0.26%(3 out of 1147 cases), 3000~3500 gm in 0.28% (5 out of 1803 cases), 3500~4000 gm in 0.92%(7 out of 758
cases),
above 4000 gm in 1.47% (1 out of 68 cases), the mean body weight was 3480 gm. The clavicle fracture incidence was increased as fetal body weight was increased(p<0.05).
6. In our study, we did not find any fetal complications vessel, nerve injury, remnant deformity, non-union and traumatic arthritis in clavicular fractured infants.
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