Clavicle, also known as collar bone, fractures are the most common injury sustained by newborns during birth. A clavicle fracture is a break in the collar bone and occurs as a result of a difficult delivery or trauma at birth. Factors that may increase a risk for a clavicle fracture include the newborn being large in size, the newborn’s shoulder getting stuck during delivery, a narrow birth canal, or the use of tools to assist with the delivery.
The most common symptom associated with a clavicle fracture in a newborn is fussiness or crying with movement of the affected arm due to pain in the clavicle. The infant may experience pain with lifting him or her under the arms. The infant themselves may not move the affected arm as much as the uninjured arm. If injury has occurred to the nerves of the arm, the infant may not be able to move the arm at all and it may hang limp at the infant’s side. The affected shoulder may appear slightly lower than the uninjured shoulder. After a few weeks, healing of the bone may cause a lump to develop at the area of the fracture, which may be felt when the area is touched.
The most significant complication associated with fracture of the clavicle during birth is the inability to move the arm due to an injury to the brachial plexus, or collection of nerves of the arm. The brachial plexus lies very close to the clavicle and may be damaged by the bone when the fracture occurs. One of 11 newborns who experience a clavicle fracture during birth will have damage to their brachial plexus, which can result in their being unable to move the arm on the injured side indefinitely or temporarily until the nerve heals.
When a clavicle fracture is suspected, an x-ray or ultrasound image of the bone is ordered to confirm that it is broken.
In most cases, clavicle fractures in newborns heal very quickly without any problems. Usually no treatment is required; however, the parent may be instructed to pin the child’s sleeve of the affected arm to the front of their clothing to avoid moving the arm while it heals.