Fractured collar bone

Alternative names
Fractured clavicle in the newborn

Definition
A fracture of the newborn’s shoulderbone (clavicle) can occur during a difficult vaginal delivery.

Causes, incidence, and risk factors
This condition is fairly common during difficult births. A clavicle fracture can occur during difficult delivery of the shoulders in a vertex (head first) delivery or during breech (feet first) delivery, when the baby’s arms are extended above the head.

Symptoms

There is generally decreased movement of the arm on the side with the fractured clavicle. Lifting the baby under the arms causes pain. Sometimes the fracture can be felt with your fingers, but more often there is no visible or palpable evidence of abnormality.

Within a few weeks a hard lump may develop where the bone is healing and may be the only indication that the newborn had a fractured clavicle.

Signs and tests

The fracture may be identified on a chest X-ray taken of the baby. Sometimes the baby’s refusal to move the affected arm may be misinterpreted as nerve injury.

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.

Expectations (prognosis)
Full recovery occurs without treatment.

Complications
There are usually no complications. Due to the excellent healing potential of infants, later in life 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.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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