Neonatal clavicle fracture in cesarean delivery: incidence and risk factors

Choi, Hae Woon; Lee, Yeon Kyung; Ko, Sun Young; Shin, Son Moon

doi:10.1080/14767058.2016.1222368

Cited by 18 publications

(22 citation statements)

References 9 publications

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“…Choi et al [ 14 ] found an incidence of 0.05% clavicle fractures ( n = 18) in their study taking into account 36.286 c-sections. Ulici et al [ 8 ] studied 136 newborns with clavicle fractures, 36 (26.5%) of whom had been delivered by c-section (with 25 elective c-sections, 18.4%).…”

Section: Resultsmentioning

confidence: 98%

Skeletal injuries after cesarean section — a rare differential diagnosis of child abuse

et al. 2023

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Birth-related fractures are an important differential diagnosis of child abuse in early infancy. While fractures associated to vaginal deliveries are well known, cesarean section is not necessarily known to cause such injuries. Nevertheless neonatal fractures have been described after cesarean sections. To give an overview over the frequency and typical locations of such fractures, the appearance of symptoms and the timespan until diagnosis, a literature research was conducted via Google scholar and Pubmed, using the key words “cesarean section” and “fractures”. Birth-related fractures after cesarean sections are rare but can occur, with the long bones being particularly affected. Therefore, birth injuries should always be considered in the forensic medical assessment of fractures in early infancy, even after cesarean section. To enable a differentiation between birth trauma and physical abuse, birth and operation records should be checked for surgical manoeuvres, possible difficulties during the procedure or other risk factors. Birth-related fractures are usually detected early; in rare cases, the diagnosis is made only weeks after birth.

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Section: Resultsmentioning

confidence: 98%

Skeletal injuries after cesarean section — a rare differential diagnosis of child abuse

et al. 2023

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“…It has also been found that the incidence of perineal tears is advanced amongst pregnant black African females than amongst other races [15][16] . The various perineal tear types incidence was institute to differ significantly under the different study conditions, with the highest incidence in hospital in comparison to social settings in Nicaragua and Sweden [17][18] . Spontaneous 1st and 2nd degree injuries of perineum (combined) accounted for 41.3% in our study, as was 43% estimated from the pooled LMICs meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors and Incidence of Perineal Tears among Pregnant Women

Mubashir¹,

Bano²,

Naeem³

et al. 2022

PJMHS

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Aim: To determine the risk factors and prevalence of perineal tear in low-risk pregnant females. Study Design: A retrospective cross-sectional study. Place and Duration: In the Obstetrics and Gynecology department of Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot for one-year duration from January 2020 to December 2020. Methods: The females with perineal tear after birth included in this study. A total of 400 females were selected for this study. Results are articulated as adjusted odds ratio (OR) and <0.05 of P value is considered significant. Results: 400 total females had singleton vaginal delivery and perineal tears were noticed in 140 females. The episiotomy frequency for the total of 1st and 2nd degree, and 3rd and 4th degree (OASI) were 16.3%, 25%, and 1.5%, correspondingly. The perineal tear risk-factors are young mothers (teenagers OR = 5.6, 21-25 years OR = 4.3), primiparous women (OR = 12.6), gestational age less than 32 weeks OR = 0.175), received antenatal care (OR = 0.42), correspondingly. Primiparous females were 12.4 times more probable to have an episiotomy (OR = 12.4, 95% CI, 1.48-104.8, p = 0.02). A birth weight between 2.5-3.0 kgs and less than 2.5 kg (OR = 0.012 and 0.084, respectively) protects against Obstetric Anal Sphincter Injury. Conclusions: The perineal injuries risk factors are comparable to those formerly described in other researches. There is an urgent need to train the gynae staff and doctors in proper selection for episiotomy and better perineal care in order to improve obstetric services in the Gynecology department. Identifying those at danger can decrease obstetric perineal injuries. Keywords: Low risk pregnancy, episiotomy, low-risk pregnancy and Obstetric Anal Sphincter Injury.

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“…Once injured, the disability rate is high, which seriously affects the quality of life of patients. There are two most common causes of clavicle bone fracture with brachial plexus injury: one is in newborns with the injury caused by the traction of the newborn’s upper limb during the delivery; the other is in adults with the injury caused by traffic accidents, falling from heights, etc [ 10 , 11 ]. The symptoms caused by puncturing a nerve at the fracture’s broken end often appear immediately after the injury [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Brachial plexus injury after clavicle fracture operation: a case report and literature review

Cao

Hou

et al. 2021

BMC Surg

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Background Open reduction and internal fixation (ORIF) is the preferred choice for treating clavicle fractures. The brachial plexus injury caused by ORIF of a clavicle fracture is very rare. If it is not treated in time, the function of the brachial plexus will be challenging to recover, which will eventually lead to upper limb dysfunction and seriously affect the patient’s quality of life. Our team recently used ORIF to treat a patient with a clavicle fracture, who developed brachial plexus injury symptoms after surgery. Case presentation A 34-year-old female patient was admitted to the hospital for 13 h due to the right shoulder movement restriction after a fall. Due to the significant displacement of the fracture, we used ORIF to treat the fracture. The surgery went well. When the anaesthesia effect subsided 12 h after the operation, the patient developed right brachial plexus injury symptoms, decreased right upper limb muscle strength, dysfunction, and hypoesthesia. Symptomatic treatments, such as nourishing nerve and electrical stimulation, were given immediately. Sixty days after the operation, the patient’s brachial plexus injury symptoms disappeared, and the function of the right upper limb returned to the preoperative state. Conclusions Patients with clavicle fractures usually need to undergo a careful physical examination before surgery to determine whether symptoms of brachial plexus injury have occurred. Anaesthesia puncture requires ultrasound guidance to avoid direct damage to the brachial plexus. When the fracture end is sharp, reset should be careful to prevent nerve stump stabbed. When using an electric drill to drill holes, a depth limiter should be installed in advance to prevent the drill from damaging the subclavian nerve and blood vessels. When measuring the screw depth, the measuring instrument should be close to the bone surface and sink slowly to avoid intense hooks and damage to the brachial plexus. Try to avoid unipolar electrosurgical units to prevent heat conduction from damaging nerves, and bipolar electrocoagulation should be used instead. If symptoms of brachial plexus injury occur after surgery, initial symptomatic treatment is drugs and functional exercise, and if necessary, perform surgical exploration.

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Neonatal clavicle fracture in cesarean delivery: incidence and risk factors

Cited by 18 publications

References 9 publications

Skeletal injuries after cesarean section — a rare differential diagnosis of child abuse

Skeletal injuries after cesarean section — a rare differential diagnosis of child abuse

The Risk Factors and Incidence of Perineal Tears among Pregnant Women

Brachial plexus injury after clavicle fracture operation: a case report and literature review

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