Fractured clavicle in the newborn

• Alternative Names

  Fractured collar bone - newborn

• Causes, incidence, and risk factors

  A fracture of a newborn's collar bone (clavicle) can occur during a difficult vaginal delivery. It is fairly common during difficult births.

• Symptoms

  The baby will not move the painful, injured arm. Instead, the baby will hold it still against the side of the body. Lifting the baby under the arms causes the child pain. Sometimes the fracture can be felt with the fingers, but usually the problem cannot be seen or felt.

  Within a few weeks, a hard lump may develop where the bone is healing. This lump may be the only sign that the newborn had a broken collar bone.

• Signs and tests

  A chest x-ray will show whether or not there is a broken bone.

  An infant's refusal to move an arm may also be due to partial dislocation of the elbow (nursemaid's elbow), nerve damage (Erb palsy), broken humerus (upper arm bone), or other causes.

• Treatment

  Generally, there is no treatment other than lifting the child gently to prevent discomfort. Occasionally, the arm on the affected side may be immobilized, most often by simply pinning the sleeve to the clothes.

• Expectations (prognosis)

  Full recovery occurs without treatment.

• Complications

  There are usually no complications. Later in life, due to the excellent healing potential of infants, it may be impossible (even by x-ray) to tell that a fracture occurred.

• Calling your health care provider

  Call for an appointment with your health care provider if your baby acts uncomfortable when you lift him or her.

• References

  Mooney JF III, Webb LX. Fractures and dislocations about the shoulder. In: Green NE, Swiontkowski MF, eds. Skeletal Trauma in Children. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 10.

Review Date: 9/2/2009

Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.