Birth trauma: fracture of the collarbone in a newborn. Prerequisites for the occurrence of a clavicle fracture in newborns during childbirth. Treatment and rehabilitation

THE CHIEF CHINESE JOINT DOCTOR GAVE INVALUABLE ADVICE:

ATTENTION! If you do not have the opportunity to get an appointment with a GOOD doctor, DO NOT SELF-medicate! Listen to what the rector of the Chinese University says about this medical university Professor Park.

And here is some invaluable advice on restoring diseased joints from Professor Park:

Read more >>>

Causes and risk factors

Most often, after birth, children are diagnosed with a fracture or dislocation of the right clavicle. The cause of the injury is simple to explain - the anatomical location of the child as it passes through the birth canal. Injury to a baby can also occur for a number of reasons:

A birth injury such as a clavicle fracture occurs for the following reasons:

• Rapid birth. The fetus does not have time to make physiological changes, as a result of which it can get stuck in the birth canal and the clavicle bone breaks.
• Helping the fetus undergo a physiological transition using hands or special tools.
• Pathological presentation of the fetus.
• Large fruit weight. A gynecologist who observes a pregnant woman is obliged to monitor weight gain expectant mother and, if necessary, prescribe a diet.
• Narrow pelvis of a woman in labor. The size of the fetus and the woman's pelvis may not correspond to each other. In this case, the doctor may recommend C-section.

More often, the fracture occurs under pressure from the narrow birth canal, but sometimes the obstetrician deliberately cuts the collarbone to get the stuck baby out.

A clavicle fracture in a newborn is the most common birth injury of the musculoskeletal system. Out of 100 newborns, 5 babies suffer such an injury.

A fracture of the collarbone in a baby during birth occurs for the following reasons:

• transverse, pelvic or leg diligence and/or precipitate labor;
• the baby is large, and the mother’s pelvic bones are too narrow;
• special dissection of the clavicular bone during childbirth, if the baby’s head comes out and the shoulders are stuck.

A clavicle fracture before 1 year of age is a fairly rare occurrence. The baby can receive such injuries:

• during a fall from the changing and massage table;
• when falling out of the stroller;
• during road traffic accidents.

The increase in the incidence of fractures from 1 year to 2 years occurs due to the beginning of learning to walk.

Most often, clavicle fractures occur from a fall on the hand or from a direct blow. A similar danger exists in every active child, but it mainly affects hyperactive children, as well as children involved in highly traumatic sports (basketball, football, gymnastics, cycling), martial arts.

Other causes of clavicle fractures in children:

• car crashes;
• sudden muscle contraction in children with epileptic seizures;
• Osteosarcoma is a malignant bone tumor.

Risk factors for clavicle fracture in newborns

Childbirth is a complex process during which it is impossible to foresee all the nuances. But there are still some prerequisites for a clavicle fracture in a newborn baby:

The clavicle is one of the bones of the shoulder girdle, on which the maximum range of movements of the limb depends due to the fact that it holds the scapula in the desired position and prevents the arm from coming too close to the chest. In adults, this is a fairly strong bone, but in newborns, injuries to it occur relatively often.

Types of clavicular fractures

All existing clavicle fractures can be divided into a number of types. So, for example, depending on the quality or presence of damage to the skin, there are closed or open injuries. Based on the number of fragments formed, we can talk about a fracture of the clavicle with or without displacement. Along the fault line, oblique, helical, ring-shaped, transverse or longitudinal fractures are distinguished.

A clavicle fracture is a complete or partial disruption of the integrity of the bone, which occurs due to mechanical impact. It is quite difficult to find out the exact statistics of clavicle damage during childbirth. The main responsibility for the health of the fetus lies with obstetricians, and not everyone will agree to believe the information about the number of clavicle fractures received from maternity hospitals.

The classification of types of clavicle is as follows:

1. Complete and subperiosteal types of fractures.
2. Closed and open (with violation of skin integrity).
3. Without displacement and with displacement (full and incomplete).
4. Transverse, longitudinal, oblique, screw, splintered.

For younger aunties, when all the bones of the skeleton are in a constant process of growth, the most typical fractures from falls are subperiosteal types of clavicular fractures, which are also called “greenstick fractures.” The analogy is not accidental.

With a periosteal fracture, the outer layer of the bone - the elastic periosteum - is not damaged, only the internal bone structure cracks, while the natural configuration of the clavicle remains almost unchanged.

Rules for treating a child

To confirm a clavicle fracture, the newborn is sent to additional examination- radiography. Treatment begins only after an accurate diagnosis has been made.

If the injury was discovered after the child was discharged, first of all, parents need to immobilize the baby’s injured arm. To do this, carefully fix the limb immobile using a soft piece of fabric.

Broken bones in newborn babies heal much faster than in adults. Doctors resort to plaster casting and surgical intervention in extreme cases. Conservative treatment consists of immobilizing the injured limb.

How to limit hand movement?

To immobilize the injured arm, a Deso immobilizing bandage is used. A cotton swab is placed in the child's armpit, and the arm is secured to the body with an elastic bandage. Average duration bone fusion takes 7 days. To fully restore functionality, the limb must be additionally immobilized for another 1 month.

If a small patient has extensive hemorrhage with swelling at the site of the fracture, he is given intravenous injections of a vitamin K solution for 3 days. If a hematoma develops, the doctor may prescribe the baby an ointment for external use (Traumel C).

If the broken bone is slightly displaced, a Deso bandage or Delbe rings are used to immobilize the arm; if the displacement is significant, a double Kramer splint is used. In case of a comminuted fracture, the collarbone is immobilized using a special splint or plate. In this case, complete recovery takes about a month. Severe injuries require surgery.

To eliminate severe pain, the baby is prescribed analgesics. Their use is possible only in a hospital setting, since these drugs are administered to infants exclusively intravenously.

Rehabilitation procedures

During treatment of an uncomplicated fracture, the child should sleep on his back or unaffected side for at least 2 weeks. During feeding, the baby should not be placed on the injured side. Rehabilitation involves the following procedures:

The duration of the course of these procedures is determined individually - depending on the severity of the fracture and the rate of bone healing. It is prohibited to perform any medical procedures without the consent of a doctor. Wrong actions can lead to serious consequences for the child. Parents need to remember that the success of the baby’s recovery largely depends on following the specialist’s recommendations.

Does mom need a diet?

A prerequisite for the rapid rehabilitation of a baby is compliance with a special diet. If the baby is breastfed, to strengthen his bones, the mother needs to include in her daily diet foods rich in microelements that are involved in the formation of the bone apparatus. These vital components include:

• calcium;
• magnesium;
• phosphorus;
• silicon.

The first thing to do is immobilize the baby's injured arm. Fixation is done using a soft roller, which is placed in the armpit, a bandage (it must be sterile) and an elastic bandage.

The fixation should not be too tight. If your child's fingertips periodically turn blue, it should be loosened.

At this point, first aid to the newborn is considered provided. High-quality treatment allows you to quickly remove the consequences of birth trauma.

Plaster is not applied to such damage.

A periosteal fracture of the clavicle in a one-year-old child, as well as older or younger, is quite difficult to determine. Such an injury does not cause sharp and acute pain. Painful sensations are perceived as discomfort. Sometimes a small subcutaneous hematoma forms at the fracture site.

The sign of a “green stick” fracture is detected only after 7-10 days. During this time, a bone callus forms after a fracture of the child’s collarbone. It is visually noticeable, and to the touch, like a dense tubercle. In fact, this is an already healed fracture of the collarbone.

Other types of closed clavicle fractures are characterized by the following symptoms:

1. Constant severe pain.
2. The fracture site becomes red and swollen. When palpated, the pain intensifies.
3. An injured collarbone looks shorter than a healthy one.
4. The child is forced to keep the injured arm bent and healthy by pressing it to the stomach or chest. In this case, the body bends slightly forward and towards the fracture.
5. When moving the injured hand, a crunching sound may be heard.
6. If the fracture is comminuted, then its fragment may protrude greatly.
7. The shoulder blade connected to the damaged collarbone protrudes and its edges become sharply defined.
8. If infant or for a child who has not learned to speak, move the handle that is connected to the broken collarbone upward, passing it through the side, the pain intensifies so much that it causes a screaming attack.

Attention! Only a doctor should reduce a simple closed clavicle fracture. The price that can be paid for amateur activity is disruption of blood vessels or pinched nerves, and with strong force, a closed fracture can turn into an open one. Give the child analgin, wrap the arm bent at a right angle to the body and go to an appointment with an orthopedist or pediatric surgeon.

How to treat a broken collarbone in a child? After clarifying the diagnosis using an x-ray, simple fractures are reduced manually, and in case of open complex comminuted fractures, surgery is performed to collect fragments of the clavicle.

Treatment of simple closed fractures depends on the type of fracture and its severity, but in general follows the following algorithm:

1. After manual reduction, a fixing bandage is applied. Only the doctor decides what type of bandage to use. The duration of immobilization is 7-10 days. Towards the end of this period, a consultation with a surgeon is necessary. Perhaps he will decide to change the type of bandage.
2. When surgically comparing fracture fragments, a fixing bandage or plaster splint is applied for 4 weeks.
3. If there is a hematoma, vitamin K is injected intramuscularly for 3 days.
4. To relieve pain and swelling, after removing the bandage for massage or exercise therapy, rub Traumeel-S.
5. Providing control over sleep on the back and “healthy” side. You can’t sleep on your stomach or “sick” side.

Today there is an alternative to a fixing bandage bandage - a corset for a broken collarbone for a child. We cannot publish the video in this article on how to apply “bandage fixations,” but the photos and drawings below will help you figure out how to do it yourself if the price of finished products is unaffordable.

In case of a “green stick” fracture, surgical assistance is no longer performed, because the callus has already formed in a child’s clavicle fracture. The doctor only determines whether the bone has fused correctly and also prescribes tests to check for the presence of diseases. skeletal system and sufficient calcium levels in the blood.

Therapeutic exercise and massage

After providing surgical assistance, treatment of children's fractures is carried out with the help of exercise therapy and massages. In order to perform them, the mother needs to learn how to properly remove and put on the fixing bandage.

Necessary physical therapy exercises:

• While wearing the bandage:
  1. flexion and extension of fingers;
  2. circular movements in the wrist joints clockwise and counterclockwise;
  3. pronation (inward rotation) and supination (outward rotation) of the forearms;
  4. circular movements in the elbow joints:
  5. neat and slow abduction (exactly to the side) and adduction of the arms, slightly bent at the elbows;
  6. for older children - static stress of the “injured” hand.
• Rehabilitation upon removal of fixation. In addition to the above exercises:
  1. passive, and then active, abduction and adduction of the arm not only to the side, but also forward and backward, while the arm should already be straightened;
  2. swinging movements with a relaxed hand;
  3. tilting the body to the sides, forward and backward;
  4. wall push-ups;
  5. lifting and lowering objects of different weights and volumes with both hands;
  6. walking and turning the body with gymnastic stick, squeezed between the elbows behind the back.

For children over 2 years old, the massage therapist can entrust the mother to perform the therapeutic procedure, but only after her preliminary training. If a child complains of pain, you can give a painkiller according to his age and in the dosage indicated in the instructions.

The doctor may additionally prescribe a course of mud therapy, electrophoresis, mid-wave ultraviolet irradiation and/or low-frequency magnetic therapy.

There are the following instructions for feeding infants after fractures:

• mothers of infants who have sustained a fractured collarbone should eat more foods that contain increased level magnesium, calcium, silicon and phosphorus;
• For bottle-fed babies, additional microelements are prescribed by the pediatrician.

For your information. After a collarbone fracture, infants do not eat well and lose weight. There's no need to worry. Healing occurs within 10 days, and then the babies quickly catch up.

Important! Medical nutrition After a clavicle fracture, you should discuss it in detail with your doctor. Excess of some microelements and vitamins can cause hypervitaminosis or poisoning.

It is quite difficult to prevent clavicle fractures in children. Nevertheless, timely surgical assistance, adequate treatment and rehabilitation lead to a complete recovery without physical defects or cosmetic defects.

A clavicle fracture in children has its own characteristic features: as a rule, the bone layer breaks during injury, but no displacement occurs. This is explained by the fact that children still have a fairly flexible periosteum, which remains intact after an impact and then performs its main function - holding the damaged bone together.

Fractures of the clavicle most often occur in childhood from 2 to 4 years, when the child does not yet maintain balance well enough and at the same time actively moves.

This injury is usually isolated and rarely occurs in combination with other bone or tissue injuries. Incomplete fractures sometimes remain completely unrecognized, since there are practically no symptoms.

Before the ambulance arrives or before going to the hospital in their own transport, parents must do the following:

1. Give your child Paracetamol or Nurofen (once!) in an age-appropriate dosage for pain relief. The effect will occur in 15–30 minutes. You will need to inform the doctor or paramedic in the ambulance, as well as in the hospital, about taking the drug.
2. Ensure complete rest for the injured limb: place a piece of rolled up fabric in the armpit, bend the child’s arm at the elbow at a right angle, tie it with a scarf to the neck and wrap it to the body.
3. Apply an ice pack or a heating pad to the site of a probable fracture. cold water for 20–30 minutes. Cold will reduce swelling and pain.
4. In case of an open fracture, stop the bleeding with a pressure bandage, treat the wound with Chlorhexidine or Furacillin solution.

It is necessary to transport a child with a clavicle fracture only while sitting or semi-sitting.

Deso bandage

If an injury occurs to a child under the age of three, a Deso fixing bandage is usually applied in the hospital.

1. A rolled-up cloth or cotton-gauze pad is first placed in the armpit.
2. The arm is bent at the elbow at a right angle and brought towards the body.
3. First, the shoulder is bandaged to the chest.
4. Further rounds of the bandage are performed as indicated in the figure.
5. The moves are repeated until the limb is well fixed.

Delbe rings, soft fixation bandage, plaster

In children over three years of age, it is not always possible to ensure immobility using a Deso bandage, especially in cases of fractures with displaced fragments. Therefore, other types of immobilization are used:

• Delbe rings - two cotton-gauze rings are put on the hands to the level of the armpits and tightened on the back, for example, with a rubber tube. The bandage provides easy muscle traction, but does not always fix collarbone fragments. Delbe rings are applied for a period of three to seven weeks. Now they are made from more modern and elastic materials. These rings are also used as a posture corrector.
• eight-shaped soft fixing bandage - shaped like the number “8”, its ends are tied on the back. This bandage keeps the clavicle fragments from moving, but does not fix them rigidly.
• rigid plaster cast - allows you to hold bone fragments in the correct position, applied with preliminary anesthesia for a period of 14 to 21 days. X-ray confirmation of clavicle fusion is required before removing the cast.

Because bones heal quickly in babies, healing a fracture takes less time. However, the general principles of therapy remain almost the same.

• Anesthesia. In a hospital setting, analgesics are used for this, which are administered intramuscularly or orally. As the pain subsides, ointments containing analgesic components are prescribed.
• Comparison of bone fragments. This is done by a traumatologist conservatively or through surgery, after which the limb is immobilized.
• Immobilization of a child's hand. To do this, use an elastic Deso bandage, placing a cotton wool roller in the armpit area and bandaging the arm to the body.

It is necessary to ensure that the bandage is not too tight, otherwise blood circulation in the limb may be impaired. In severe situations, splints are used instead of a bandage.

Usually bone fusion occurs within 7 days, but the fracture heals completely within a month, so the limb is fixed for 18 days or more (this depends on the nature of the injury and the method of treatment).

In the first 14 days, as a rule, it is forbidden to place the baby on the side where the collarbone is damaged.

It is important! Do not try to set the bones yourself, as this can damage important blood vessels and nerves. Do not leave your child without qualified medical care - to avoid serious complications, go to the hospital immediately.

Signs of a fracture

A fracture of the collarbone during childbirth in a child is diagnosed in the maternity hospital. Often such injuries are noticed by neonatologists in the delivery room during the first examination of the baby. Sometimes bone integrity problems appear the next day.

Young mothers should know the symptoms and manifestations of fractures in order to promptly contact doctors for help:

1. The baby's tearfulness, his poor health;
2. Disturbances in sleep, diet, complete refusal of breastfeeding;
3. Limited hand mobility;
4. Swelling and hematoma in the collarbone area;
5. Crying when pressing on this area due to severe pain.

If any of the above symptoms appear, you should immediately let your doctor know about them. In some maternity hospitals, unscrupulous doctors are silent about the presence of injury, although they themselves immediately notice it. Their motivation is simple - if a fracture is detected at home, then it is problematic to prove that it was caused during childbirth due to the incompetence of the doctor.

If you see that something is wrong with the child, he is acting restless, does not sleep, does not eat, and constantly cries, raise the alarm. Don’t leave a choice to the medical staff; insist on an examination.

A clavicle fracture in an infant is diagnosed by a neonatologist during an examination of the newborn after birth. Characteristic symptoms:

• severe crying during palpation;
• smoothness of the supraclavicular region;
• redness and swelling of the soft tissue that surrounds the broken bone;
• friction and crunching of bone fragments during palpation;
• in case of a displaced fracture - violation motor activity hands;
• refusal to eat and, as a result, slow weight gain.

If these symptoms are detected, parents should urgently take their baby to the doctor.

As a rule, a neonatologist makes a diagnosis of a newborn during the first examination of the baby based on the following signs:

• palpation of the clavicle area causes the baby to cry,
• the crunching of bone fragments is heard, their friction against each other is felt,
• difficulty moving a limb,
• the supraclavicular fossa is smoothed out,
• bone deformation is visible.

Due to the fact that the newborn experiences pain and discomfort, he becomes very restless, his appetite decreases, and the baby does not gain weight well.

After a few days, swelling and redness of the soft tissues appear in the area of ​​the fracture.

To confirm the preliminary diagnosis, it is necessary to take an x-ray.

It is important! Without proper treatment, a child develops a false joint within a week, which leads to pathological mobility of the bone, and therefore requires mandatory surgical intervention.

Symptoms

Sometimes the position of the fetus in the uterus is such that a fracture of the child’s collarbone occurs during childbirth. This can happen if labor progresses quickly. If the child at this moment was in a breech, facial, transverse or leg presentation, he will not have time to roll over into the correct position, and the main pressure will be transferred to the shoulder and thoracic regions.

The collarbone can also be damaged by instruments used during childbirth. Doctors often donate this bone themselves if they cannot otherwise remove the child. The collarbone heals quickly, and prolonged labor can harm the woman and child much more than such a fracture.

The injury is diagnosed by a neonatologist. Its signs:

• increasing crying of the child when feeling the collarbone;
• swelling and hyperemia (redness) of soft tissues in this area;
• smoothed supraclavicular fossa;
• limited arm movement (in severe cases);
• characteristic crunching of the bone upon palpation (bone crepitus).

Fractures also occur when the sizes of the woman’s pelvis and the fetus do not match, as well as when the child’s skeleton is fragile. If the diet during pregnancy was poor and poor in vitamins, protein and minerals, in particular calcium, the fragility of the newborn’s bones may be increased. But regardless of the cause, the symptoms of the injury are the same.

The right collarbone is most often affected. When a fracture is diagnosed, the child is given first aid, and the woman is explained how to properly care for such a child.

The course of treatment for such an injury is short-lived - bones at this age grow together much faster than at an older age.

Fracture without displacement

Take a close look at what symptoms you have, even if their external manifestations are minor. Young children have very flexible bones; a typical incomplete fracture, which traumatologists call a “green stick,” may occur. The inner layers of the bone break, but are not displaced due to the flexible periosteum. Safe and sound, it continues to hold together the damaged areas of the child’s collarbone.

There is no displacement, pain is minimal, the symptoms of a fracture are not clearly expressed, with the exception of hemorrhage in the area of ​​the injury. It is difficult to determine a closed fracture without displacement, so it is often mistaken for a regular bruise.

Gradually the bruise fades, after about two weeks a compaction appears on the clavicular bone - a callus, the damaged shoulder girdle becomes shorter. The bone will heal on its own, but not always successfully. There is still time to go to a traumatologist. He will prescribe x-rays, treatment and set the bone if the fusion is not happening correctly.

Displaced fracture

Symptoms of displacement can be identified even by an inexperienced person; they are visible upon a superficial examination. With a complete fracture, fragments of the clavicle bone are clearly visible under the skin. If a broken bone has broken through the muscles and skin, help should be urgent - these are signs of an open fracture.

You will also notice other symptoms:

• immediately after the injury, the child complains of very severe pain;
• cannot lift the injured arm, presses it to the body;
• the injured shoulder is lowered, unnaturally pushed forward, displaced inward;
• the forearm is swollen and swollen, hemorrhages are visible;
• the affected arm seems longer;
• the shape of the collarbone has changed;
• If the child moves his hand, a crunching sound is heard.

A displaced fracture can be complicated by damage to important nerves and blood vessels. To check for signs of damage, ask your child to move his fingers and hand.

Fractures without displacement of the bone fragments of the clavicle are considered milder injuries, since the presence of displacement is fraught with a number of unpleasant consequences. Before you begin to provide first aid to the victim, as required by the instructions, you should familiarize yourself with the main symptomatic signs.

The following symptoms may indicate a violation of the bone integrity of the clavicle:

• pain in the shoulder joint;
• the appearance of edema;
• bluish or pale skin color;
• bleeding (they can be both external and internal);
• deformation of the shoulder contours (basically the shoulder drops and therefore protrudes forward, which is why the upper limb visually becomes longer);
• inactivity of the fingers on the injured hand.

In addition, the victim may complain of numbness in the arm, which may indicate damage to the nerve endings. Bone elements may overlap each other when receiving a strong blow. Visually, the shoulder blade may protrude more or “sag.”

Immediately after the injury, the site of the impact begins to swell rapidly, since fragments of the clavicular bone, due to their sharpness, increase the risk of rupture of adjacent blood vessels. Such displacements of fragments increase the pain syndrome in the victim.

Due to significant pain, the person is forced to support the forearm and elbow with the help of a healthy limb. The least painful position is when the injured arm is pressed to the body, so it is practically impossible to move it. Palpation allows you to determine the presence of pathological mobility and crepitus of bone fragments.

A qualified doctor can easily establish an accurate diagnosis if the above-mentioned symptomatic signs are present and are pronounced. Despite this, confirmation of the diagnosis is carried out during x-ray examination injured upper limb.

An X-ray allows you to study in more detail the displacement of the bone elements that has occurred, as well as determine the severity of the injury. This study is considered a mandatory diagnostic procedure, since it makes it possible to distinguish a dislocation from a broken collarbone.

Diagnostics

X-rays are not recommended for newborns, but they are necessary in case of a fracture. Don't worry too much about this. Radiation doses are selected very carefully to minimize potential harm. If you treat a baby without such an examination, the likelihood of improper bone fusion increases.

The only problem that can be encountered during an x-ray examination is that it is problematic to immobilize the baby. The study is carried out during sleep or under the influence special drugs.

Based on the images taken, the doctor selects the appropriate treatment tactics. Pediatric traumatologists often encounter similar injuries, so there is no need to doubt their competence.

Determining a fracture in a newborn is quite simple. As a rule, already during the postpartum examination, the doctor will definitely notice swelling in the area of ​​the fracture. To rule out dislocation, an x-ray examination is prescribed.

It is important for parents to remember that if the collarbone is fractured or dislocated, the child needs to be given first aid. Under no circumstances should you try to move the bones back, do not tug, and certainly not press. Bone fragments can compress blood vessels, nerve endings, or even break through the skin.

What do you need to know when providing first aid? Let's look at it:

1. Give pain medication.
2. Fix the arm in a bent state to provide rest to the fracture site.
3. Safe transportation of a child to a doctor - traumatologist or surgeon.

It is important for parents not to overdo it with guardianship, but to follow the above rules with a cool head.

For children who have broken their collarbone, the doctor will initially conduct a visual examination, establish all the symptoms and external manifestations, and then send them for a hardware examination. A complete fracture is characterized by rupture of the periosteum, which causes severe pain and swelling.

After making a preliminary diagnosis, the traumatologist prescribes the following studies: radiography, if necessary computed tomography or magnetic resonance imaging. If damaged vessels, nerves, pleura or lungs are suspected, consultation with a surgeon, pediatric neurosurgeon or thoracic surgeon should be sought.

If a lung ruptures, a chest x-ray is performed.

Treatment

Treatment for a clavicle fracture involves fixing this area in a certain position. The doctor applies a special bandage.

A special roller is installed in the armpit to ensure abduction of the limb at the required angle. The shoulder, shoulder blade and collarbone are securely fixed. For such purposes, an elastic bandage is used. It should not put much pressure on the soft tissues, otherwise the blood supply will be disrupted.

If your baby's limbs turn blue, ask your doctor to loosen the bandage.

You need to wear it for 2-4 weeks. the fracture heals within a week, because in children the recovery process is much faster than in adults, but the bandage will have to be worn for some more time to restore all functions of the limb and ensure the correct physiological position of the shoulder girdle as they grow up.

Reposition and fixation bandages

In the department, a pediatric traumatologist will deal with a fracture of the child’s collarbone. He will prescribe treatment on an outpatient basis, except in cases with open fractures, severe displacements, or the threat of damage to the lung, blood vessels, nerves, and skin.

When treating incomplete fractures and those with slight displacement, the doctor will apply a scarf bandage, Deso bandage, and Delbe rings. If the child has confirmed symptoms of displacement, the traumatologist will perform a reposition - he will set the displaced bone fragments.

For young children, the manipulation is performed under general anesthesia; for older children, local anesthesia is given. Then he will apply a special fixing bandage.

It is very difficult to hold displaced bones until they heal completely. It is advisable to use only methods that will provide functional treatment. Deso bandages and adhesive plaster according to Sayre poorly fix the fragments, immobilize the shoulder joint, and provoke its immobility in the future.

They are only good for temporary fixation. A plaster cast has similar disadvantages. Treatment of a displaced fracture involves more recommended methods: Beller splint, Delbe rings, double Cramer splint, fixation on the oval.

In case of an incomplete fracture, the bandages will remain on the child’s arm for 2-3 weeks, in case of displacement – ​​up to 4 weeks. The ability of the injured arm to work will be fully restored after a couple of months of rehabilitation.

Surgical treatment

Surgery for a clavicle fracture is rarely required. Only carried out in case of serious injuries:

• open fracture;
• severe displacement that cannot be eliminated by reposition;
• damage to the skin, nerves, blood vessels, lungs;
• neuralgic pain in the arm;
• excess callus.

The child will undergo the operation under general anesthesia. If the fracture is located on the middle part of the clavicular bone, osteosynthesis will be performed with knitting needles, a pin, or S-shaped reconstruction plates. If the acromial end has been damaged, a hook plate or a plate and locking screws will be required.

After the operation, the child wears a scarf for some time. In a week, the stitches will be removed and restorative treatment will be prescribed: electrophoresis, restorative massage, magnetic therapy and exercise therapy.

To treat a fracture or dislocation, standard procedures are carried out, first of all it is necessary to apply a fixing bandage. Treatment proceeds in the following sequence:

• Anesthesia of the injured area with local anesthesia.
• It is necessary to collect the fragments of the collarbone and place them in the correct position. During this procedure, a thick gauze roll is placed under the child's arm.
• Apply a figure-of-eight bandage or Deso to ensure immobility of the injured area.

A clavicle fracture is a common injury not only in newborns. To treat a 2-3 year old child, a figure eight bandage is used, which is applied for 2 weeks. For an older child, a combined version of the bandage is suitable.

For effective bone healing, it is necessary to use a plaster cast. This treatment helps to save the collarbone almost 100%. Before applying plaster, it is necessary to correctly align the bone fragments.

There are cases of improper bone healing. If this negligence is not corrected or the fracture is not treated at all, the bone will heal incorrectly and a deformity of the shoulder will occur. In such cases, the treatment is repeated, which means the bone must be re-broken.

A clavicle fracture in a small 1.5 year old child can be treated quickly. There may be several treatment options; the attending physician will choose the most appropriate one in a particular case. As a rule, young children are prescribed a fixing bandage. When treating, you need to adhere to the following sequence:

• the injured area is numbed;
• bone fragments are returned to their original position;
• immobilize the shoulder and fix the injured area using a figure-of-eight bandage.

It is also convenient to use the so-called Delbe rings for fixation - this is a ready-made splint for treating a clavicle fracture. The application of bandages is carried out exclusively by a specialist, since with this procedure there is a high risk of additional secondary displacement of bone fragments and, as a result, improper fusion.

Another popular method for treating an injured collarbone is applying a plaster cast. In more than 90% of cases, recovery is successful.

It should be remembered that before applying plaster, it is necessary to restore the bone fragments to the correct position. If this is not done, the shoulder joint may become deformed - shortened due to improper restoration of the normal length of the shoulder girdle.

In cases where the displacement by a fragment cannot be manually restored, surgical intervention may be necessary, during which all fragments are folded into their original natural position. This operation is called osteosynthesis.

The success of treatment for violation of the integrity of the clavicular bone depends on the following factors:

• the severity of the injury;
• volume of damage;
• age category of the patient.

Severe cases require surgery. The comparison of bone fragments is carried out during reposition, which is carried out under local anesthesia. Thus, it is possible to achieve correct fusion of clavicle fragments after injury.

After repositioning, the limb should be immobilized for three to eight weeks. For this purpose, a special fixing bandage is used. Pain syndrome is relieved with the help of analgesics.

As a therapeutic course, it is mandatory to take:

• anesthetics;
• antibiotics (for open injuries and postoperative sutures);
• general strengthening, immunostimulating agents;
• vitamins;
• medications to replenish the body with calcium.

Physiotherapeutic treatment consists of electrophoresis, magnetic therapy, ultrasound, laser therapy and ultra-high frequency therapy. After the fusion of the bone fragments of the injured clavicle is confirmed, the patient is prescribed physical therapy, massage procedures and warm salt baths, which are the final stage of treatment for a clavicle fracture.

The most comfortable position for the victim depends on the severity of the injury and how it is treated. How a child sleeps with a clavicle fracture is influenced by the presence of a fixing agent: it can be a plaster cast, Delbe rings or a Deso bandage.

Among possible options The most rigid fixation is considered to be a classic plaster cast, which must be applied over the shoulder and chest. It is not recommended to apply it if the patient is over fifty years old, since rigid immobilization provokes the development of arthrosis.

Applying any bandage for a clavicle fracture is the same. The patient needs to sit on a chair and lean firmly on his back.

There are certain indications for surgical intervention for a clavicle fracture in a child:

• open fracture;
• impossibility of combining fragments (with strong displacement);
• comminuted fracture;
• damage to blood vessels, nerves or lungs.

The operation is performed under general anesthesia. For older children, regional anesthesia may be performed. Local anesthetics - novocaine or lidocaine - are injected into the area near the brachial plexus. This allows you to completely eliminate sensitivity at the surgical site for some time.

Currently the most common are following methods osteosynthesis (clavicle restoration):

After osteosynthesis, the application of a Deso bandage and the administration of Paracetamol or Nurofen are usually required.

Advantages of surgical treatment of a clavicle fracture:

• after the operation, the child can move his arm already on the second or third day;
• the bandage is removed after 2 weeks;
• the operation ensures correct comparison of fragments.

Complications of surgical intervention occur in 1% of cases:

• Non-union of the clavicle (with incorrect selection of the fixator, comminuted fracture);
• infection (osteomyelitis) - if the rules of asepsis are not observed. To prevent this complication, the child is given an intravenous broad-spectrum antibiotic 30 minutes before surgery. In the postoperative period, the same drug is continued orally for 7–10 days.

In addition to complications, you need to remember to remove the fixators. This is a repeated operation, which is carried out at different times, depending on the type of metal structure (usually no earlier than a year later).

Application technology, care

The product must be positioned in a special way so that it is in maximum contact with the body, otherwise the rings will move and rub the skin. The device is worn all day, but taken off when sleeping.

In this case, the doctor must independently determine the degree of back deflection. Also, you cannot independently determine for yourself the period of use of the rings, especially in case of a fracture.

In order for the device to work properly, it must be looked after in a certain way:

1. Before washing, it is important to fasten all fastenings;
2. Wash by hand or set the machine to manual mode (water temperature no more than 40 degrees);
3. Do not wash the device with other clothes;
4. For washing, use only detergent for delicate items;
5. The rings must not be twisted or ironed; they must dry naturally.

First aid for a child

Do not try to straighten the displaced parts of your child’s collarbone yourself! Between them are muscles, nerves and large vessels. With an awkward movement, you will injure them with sharp bone fragments, which is fraught with bleeding and the threat of muscle paralysis.

Such manipulations, as well as applying bandages, are carried out only by traumatologists. However, competent and timely first aid, which can alleviate the child’s suffering and protect him from additional damage, is still necessary. If you notice a fracture, you can:

1. Give the child paracetamol or analgin for pain relief.
2. Provide rest to the injured arm and protect it from further displacement of the bones. You need to place a ball of cotton wool or rolled fabric in the armpit area. Bend the child's arm at the elbow at a right angle. Tie it with a scarf to your neck and wrap it to your body.
3. If there is an open fracture, stop the bleeding with a pressure bandage. Treat wounds with a bactericidal agent.
4. Take the child to the trauma department. Make sure that the baby only sits during transportation.

It is strictly forbidden to try to straighten the child’s collarbone yourself, since if you do it ineptly, the bone can move even further and at the same time damage large vessels, nerves and muscle tissue. Applying various bandages, splints and other means of fixation without proper medical training is also dangerous.

To provide competent and timely assistance to the child, prevent additional damage and reduce pain, it is recommended:

• Give painkillers - "Analgin" or "Paracetamol".
• You can put a ball of cloth or cotton wool under your arm, bend your injured arm at a right angle and tie it to your neck with a scarf. The injured arm should be at rest.
• In case of an open fracture, it is necessary to stop the bleeding with a tight bandage, then treat the wound with antiseptic agents.
• You should go to the emergency room as soon as possible. During transportation, the child must be in a sitting position.

In the maternity hospital, after X-ray confirmation of the diagnosis, specialized care is provided by a pediatric traumatologist. The nature of such assistance will depend on the type of fracture (open, closed) and the degree of its severity (simple, displaced, multiple, etc.).

Before examination by a traumatologist, the limb is fixed in a certain position, placing appropriate pads and fixing the injured limb to the baby’s body.

If for some reason the parents discovered a fracture of the collarbone after discharge from the hospital, then you need to do the following:

• Secure the arm in a bent position with a scarf. In this case, you should ensure that the limb is bent at the elbow at a right angle.
• Seek medical help immediately.

Contraindications and side effects

1. Clavicle fracture is the most common medical problem for which the device is indicated;
2. Rupture of the joint in the clavicle area;
3. Poor posture, but only in the initial stages;
4. Pathologies of the spinal column associated with dystrophic and degenerative changes - kyphosis, scoliosis, pterygoid blades;
5. Underdevelopment and osteochondrosis of the thoracic spinal column;
6. Osteoporosis and spondylopathy.

The device can only be used as prescribed by a specialist; there are special indications for this. Despite the fact that rings have no contraindications and side effects, wearing them uncontrollably is prohibited. The only contraindication to the use of rings may be allergic reactions to the material from which they are made.

Side effects are possible only in the form of allergic reactions on the material of manufacture.

Consequences of injury

If a clavicle fracture in a newborn is left unattended, the consequences of the injury can be tragic. The child will remain disabled because the mobility of the arm and shoulder blade will be impaired. Over time, such changes become irreversible. For this reason, it is so important to promptly identify the injury and begin urgent treatment.

Inflammation develops at the fracture site. If you do not pay attention to this, the weakened body will be overcome by infections. There is a possibility of developing sepsis.

Timely diagnosis and treatment of a clavicle injury allows you to avoid any complications. In rare situations, when the infant’s immune system is weakened, an inflammatory process may develop at the fracture site.

In addition, in some cases, if the broken bone is improperly fixed or if there is significant displacement, a false joint can form - poor fusion of bone tissue, which leads to impaired performance of the limb.

In addition, a fracture of the clavicle in an infant can cause damage to the brachial plexus or neurovascular bundle. The listed consequences of birth trauma are recorded very rarely, so a fracture of the collarbone during childbirth is not a pathology dangerous to children's health.

In the vast majority of cases of clavicle injury in infancy, no serious consequences were observed. This is only accompanied by the fact that after birth, such children begin to lose significant weight due to the fact that they have a decreased appetite and they refuse breast milk.

The activity of the immune system may decrease in an infant, which increases the likelihood of developing an infectious process. If the injury was treated correctly, it will not affect the child’s musculoskeletal functions in the future.

If the treatment is carried out unskillfully, the injured collarbone does not heal for a long time, and a so-called false joint may form at the site of the injury.

In the worst case scenario, bleeding may occur as a result of damage to the nerve and vascular bundles behind the collarbone. An orthopedist or pediatric surgeon should treat such injuries.

Thus, it is necessary to prepare for the birth of a baby as seriously as for its conception. Otherwise, such damage can overshadow the joy of motherhood and childhood. Therefore, the choice of a maternity hospital and an obstetrician-gynecologist who will deliver a child during labor should be approached with all responsibility.

After all, already at this stage, parents are responsible for the life and health of the baby, who is about to be born. And it is important to prepare for such a significant event and take care of everything in advance.

Longer treatment may be needed if the child has an open fracture or damage to the subclavian nerves and arteries.

Sometimes, due to complex injuries, the collarbone cannot restore its original length, so the forearm remains slightly shortened and deformed.

Incorrectly fused clavicular bone fragments and overgrown callus can put pressure on the nerve plexuses, causing chronic pain and minor difficulties during physical activity. The same phenomenon is observed with the formation of a “false joint” - the consequences of a non-united clavicle fracture.

Even if the bones have not fused completely correctly, there are no significant disturbances in the functioning of the arm and shoulder girdle of children, except in cases where the shoulder girdle was immobilized for too long during treatment.

Usually in newborns, a clavicle fracture heals quickly and without a trace. In isolated cases, infection, severe pain (with nerve damage), and prolonged nonunion (with severe displacement and improper fixation) may occur. All these conditions are treated in a hospital setting.

The prognosis is favorable. Recovery occurs within 12–20 days; after a fracture of the collarbone, there are no physical or cosmetic defects left.

Prognosis and complications in older children

In older children, visual deformation in the area of ​​the injured collarbone and a shortened shoulder girdle may remain. It is known that when the bone heals within 1.5–2 months, a bone callus is formed.

This is a physiological phenomenon, but there are cases when it grows excessively or becomes inflamed. In these conditions, there is chronic pain and limited movement of the injured collarbone.

The same phenomena can be observed during the formation of the so-called “false joint” - a pathological joint that forms at the site of inaccurate comparison of fragments of the clavicle. But more often such a growth is painless. If it causes discomfort, surgery is performed to remove it.

The prognosis is favorable. The normal length and shape of the collarbone, as well as full range of motion, are restored within 2–3 months.

A clavicle fracture is a common injury in both newborns and older children. It cannot be prevented. How younger child, the faster the recovery after a fracture, since the bones break like a “green twig.” If treatment and rehabilitation are carried out promptly and competently, the consequences of a clavicle fracture in children will be reduced to zero.

Preventive measures

Is it possible to avoid injury to a baby during passage through the birth canal? To do this, you need to follow the following recommendations:

Where to buy and how much it costs

There are a huge number of manufacturers of Delbe rings, among them there are domestic and foreign brands. It is better to purchase products from companies that specialize in the production of orthopedic equipment. It is better to buy rings at a pharmacy or specialized medical center.

In addition, you can buy a device in an online store, but first you need to make sure it is reliable point of sale.

Before placing an order, you need to carefully study all the characteristics of the product, make sure that it fits in size and meets quality standards - it is made of natural materials.

The cost of Delbe rings depends primarily on the manufacturer. The average price is 1200 rubles. Children's and adult models cost approximately the same.

Almost every pregnancy ends in childbirth. The birth of a baby is a complex, physiological process, even if the birth was quick. A clavicle fracture in newborns is a common pathology that does not depend on the course of pregnancy. In infants, a fracture in the collarbone is diagnosed for the first time minutes or days of life.

The concept of a “newborn clavicle fracture” is associated with pain, swelling or bruising, and is an anomaly in the anatomical integrity of the clavicular bone, which is connected to the sternum and scapula.

Causes of pathology

During childbirth, damage occurs as a result of strong pressure, rotation of the baby, or due to the fact that the mother’s pelvis is narrow and the baby is large in size. Sometimes it is even necessary to cut the collarbone if the newborn’s shoulders get stuck in the birth canal. When the child is older, collarbone fractures or cracks occur much more often. The baby fell on his elbow or outstretched arm, as well as with a direct blow to the collarbone.

Types of fracture

Based on the location of the bone fragments, the following types of injury are distinguished:

• Displaced clavicle fracture. The bone fragments are displaced relative to each other. Displacement occurs with fractures such as:
• complete - the wreckage is scattered.
• incomplete - the integrity of the bones is largely preserved.

The collarbone is broken without displacement. Such injuries heal much better.

But most often they occur closed fractures. With such injuries, the skin remains intact.

According to the fault line, a broken collarbone is divided into the following types:

• T-shaped.
• Transverse.
• Oblique.
• Helical.
• S-shaped.

This division of fractures carries great importance, since the choice depends on the type of injury effective treatment, without serious consequences.

Important! A clavicle fracture in children occurs due to the fact that the bone tissue is soft, but they are able to quickly recover after birth trauma.

Symptoms of a clavicle fracture

4 days after the birth of the baby, a spindle-shaped compaction becomes noticeable above the collarbone - a callus has grown. There may be bruising and swelling over the fracture. The child’s well-being usually does not suffer with this fracture, but there is anxiety and crying at the time of changing clothes, refusal to eat and significant weight loss.

If there was a displaced fracture at birth, then the movements of the arm on the side of the broken collarbone will be limited. When you move your hand and palpate the clavicle area, a crunch or crepitus appears - this is the result of friction of the debris.

Children under 12 years of age most often suffer from a greenstick fracture. This type is not a classic fracture, but small cracks throughout the bone. The pathology depends on the child’s metabolism and the degree of bone mineralization. An injury in a child is manifested by symptoms of a bruise: bruise, swelling, discomfort when moving the hand on the injured side. General state child is normal.

Over time, the bruise becomes paler, and within two weeks a callus will form on the collarbone, indicating that the clavicle bone is healing. The damaged arm becomes somewhat shorter.

Important! If a bone compaction is detected on the collarbone, it is necessary to urgently consult a specialist, since the bone does not heal properly, and at the initial stage this pathology can be treated without complications.

If the collarbone is broken and the fragments are displaced, the following symptoms will occur:

• There is an uneven surface above the collarbone; damaged bones can be felt under the skin.
• In the clavicular area there is swelling, bluish discoloration of the skin, severe pain.
• It is convenient for the child to hold the torso in the direction where the collarbone is broken and at the same time he presses the damaged limb to the body.
• Visually, the arm looks turned inward, shifted forward and longer than the healthy limb.
• The edges of the shoulder blade become clearer, and the blade itself sags slightly.
• Palpation of the damaged area is painful.
• Restriction in arm movement on the side of the clavicular fracture.
• When moving there is a crunching sound.
• When you raise your arm up, pain occurs.
• The fingers of the injured limb become less sensitive.

If you detect at least one of the above signs, you should immediately consult a doctor, who, using a visual examination or medical equipment, will establish the correct diagnosis. This is necessary so that the treatment gives a positive result and the consequences are insignificant.

Diagnostics

To make a diagnosis, the doctor takes an anamnesis and prescribes an x-ray of the collarbone in a standard straight position. In difficult cases, computer or magnetic resonance imaging of the clavicle is prescribed.

If there is concern that the fracture is accompanied by damage to blood vessels, nerves, or respiratory organs, a consultation with a vascular surgeon, thoracic surgeon, and pediatric neurosurgeon is scheduled. If there is a suspicion that a newborn or child has a lung injury, a chest x-ray is performed in a direct projection.
First aid and treatment

Regardless of age, a child with a collarbone injury should be given first aid. But you can’t fix a broken bone on your own. It must be remembered that if broken bones are not joined professionally, nerves, muscles, and blood vessels can get between them. All this can lead to serious pathologies, including paralysis.

To provide first aid, the following instructions must be observed:

• Use painkillers.
• The arm must be fixed in a position bent at the elbow. This will help provide rest to the damaged area.
• Take the child to a specialist - a surgeon or traumatologist.

Trauma is treated in several ways. To begin with, if a child has a fractured collarbone, a fixing bandage is applied to him, and treatment is carried out in a certain sequence:

• Local anesthesia is administered to the injured area.
• Next, the clavicle fragments are assembled into the correct position. During this procedure, a thick cotton-gauze roller is placed in the baby’s armpit.
• The child’s shoulder must be immobilized to ensure that the bone fragments do not move. For fixation, use a Deso or figure-of-eight bandage.
• For children aged 2 to 4 years, a figure-eight bandage is used, which will be removed after two weeks. For an older child, it is necessary to use combined options.

Also, when treating a fracture, a plaster cast is applied. In 95% of cases, this treatment helps the collarbone heal completely. But a plaster cast alone will not correct the existing displacement of the fragments, so before the plaster cast, the broken bone should be aligned in the correct position.

If the fracture is not corrected, then after the cast is removed, deformation of the shoulder joint will remain and the treatment will have to be repeated, and for this the bone must be broken again.

If the displacement is not corrected, then a thickening of the clavicle is subsequently revealed that has formed at the site of the fracture, which indicates that the existing fragments have grown together. In the future, the callus will become smaller, but the deformation of the clavicle due to improper fusion will not be eliminated.

If, when the fragments are displaced, the violation cannot be eliminated manually, then the defect should be treated using osteosynthesis.

Consequences

Timely measures taken will help the baby recover quickly, and there will be no serious consequences for his health. The main task of parents and doctors in this situation is the correct diagnosis and fixation of the bandage, which otherwise can lead to non-union of the bone and the formation of a false joint. If a fracture or crack occurs in a baby during childbirth, damage to the brachial plexus may occur.

Do not delay diagnosis and treatment of the disease!

Make an appointment with a doctor!

A clavicle fracture in newborns during childbirth is a common injury in which the integrity of the clavicular bone is disrupted. According to the latest statistics, there are 11-12 cases per 1000 newborns. The fracture occurs during childbirth and does not depend on the course of pregnancy. It is important that the doctor makes a diagnosis in time and begins treatment to avoid consequences. Bone damage is diagnosed almost immediately after birth. Sometimes, due to the appearance of edema and hematoma, the diagnosis is made several days after birth. Rehabilitation measures play an important role in the restoration of the collarbone and joint.

If the injury is diagnosed in time, there are usually no serious consequences at this age. But if the injury is serious and not detected in time, the baby’s immunity decreases, which creates a risk of developing infections. A promptly identified, correctly treated fracture does not subsequently affect musculoskeletal function joint If it was treated incorrectly, the collarbone may not heal for a long time, and a false joint appears at the site of damage.

In rare cases, fragments of a broken collarbone provoke bleeding due to damage to the neurovascular bundle.

The collarbone is a thin tubular bone that connects one end to the chest and the other to the shoulder blade. During childbirth, the right collarbone is more often broken, this is due to the physiological position of the fetus during childbirth. The causes of such injuries in newborns can be different. There are a number of main causes of clavicle fracture during childbirth.

In some women, labor occurs so quickly that the fetus does not have time to take the correct position and is injured as it passes through the birth canal. This is one of the reasons why the clavicle bone breaks during childbirth in babies.

Unqualified medical assistance

If childbirth is difficult, the baby is stuck in the birth canal, doctors help the baby by turning him over. Through carelessness or lack of experience, in a hurry, the doctor touches the newborn’s body, breaking a collarbone or arm.

The size of the newborn is larger than the size of the birth canal

The baby inside the mother grows so big that, passing through the mother’s narrow birth canal, it causes harm to both itself and her. The doctor, having examined the baby during an ultrasound examination, is obliged to warn the mother about the large fetus and the consequences of its passage through the birth canal, and that there may be complications during natural childbirth. In this case, gynecologists suggest a caesarean section.

Malposition

Injury can occur if the baby is positioned incorrectly in the uterus, for example, with the buttocks forward. As the baby passes through the birth canal, it puts a lot of pressure on its bones. In this case, the collarbone can be damaged due to the load.

When a baby is born, the correct position is head forward, all the pressure and load is taken by the baby’s skull, which is much harder than the bones, and therefore the baby passes through the tight birth canal without any problems.

Brittleness and softness of bones

A fracture will occur if the child has brittle bones due to a serious genetic disorder. Fractures often occur due to the softness of the bone tissue of the baby’s collarbone, but after injury they quickly recover.

Main symptoms

It is not difficult for an experienced doctor to understand that a fracture of the collarbone of a newborn occurred during childbirth - the injury has pronounced signs of fractures:

• hematoma in the affected area, swelling;
• when swaddling the baby cries all the time;
• when palpating the affected area, a specific crunch is heard;
• the baby does not move his arms in the same way;
• in especially severe cases, when fragments are displaced, the handles are limited in movement.

If the doctor did not diagnose the injury in time, a clearly defined bone callus can be felt at the fracture site after a week. Having noticed a callus, parents should, after discharge from the hospital, make an appointment with a pediatric surgeon. To make an accurate diagnosis, the baby is prescribed x-ray diagnostics.

First aid for newborns with a broken collarbone

A damaged collarbone in a newborn must be immobilized during childbirth. This is done using a Deso bandage. The arm in a half-bent position is bandaged to the baby’s body. If swelling or hematoma is found at the fracture site, the doctor prescribes vitamin K injections, which are administered intravenously. Traumeel S with an analgesic, anti-inflammatory and regenerative effect or another ointment as prescribed by a doctor is applied to the fracture site. The gel is rubbed all over the handle to obtain a rapid therapeutic effect.

During the entire time that the baby’s arm is in a bandage, it is recommended to place it only on the healthy side. In an infant, the clavicle fracture heals completely after three weeks. And if everything is done correctly, no complications, as a rule, are observed.

Effective treatments

In newborns, the rate of bone tissue recovery is amazing. This feature protects young children from the consequences of fractures at birth. If the collarbone is broken by an adult, the formation of a callus occurs within two to three weeks; a clavicle fracture in newborns begins to heal within a week, and after 20 days it is restored.

For newborns with a clavicle fracture, plaster is not applied to the fracture; a Deso bandage is used when the injured limb is tightly bandaged to the body in a bent state. A soft cushion made of cotton wool and bandage is placed under the baby’s armpit. Parents should ensure that the baby lies on his healthy side at all times until recovery.

If the fingers on a bandaged hand turn blue, this indicates poor circulation. In this case, it is necessary to loosen the bandage.

Rehabilitation period

Rehabilitation includes a range of physiotherapeutic procedures:

• massage of the limb and joint, which should be carried out by a specialist;
• therapeutic and recreational exercises under the guidance of an experienced rehabilitation therapist;
• magnetic therapy sessions;
• electrophoresis sessions (promote better penetration medicines through the skin to the broken bone).

The rapid recovery of the baby is facilitated by the intake of vitamins and nutrients into the body through mother's milk. During this period, a woman needs to fill her diet with foods containing calcium, phosphorus, silicon and magnesium - microelements that promote bone tissue restoration.

10765 2

The clavicle is a tubular bone connected at one end to the acromion process of the scapula and at the other to the sternum.

The fragment may shift under the pull of the muscles, depending on the nature of the damage received.

The share of such damage the highest percentage is rolled, and statistics show that no one is immune from such a problem.

Therefore, the information will be very useful for mothers.

Causes of fracture

A clavicle fracture in a newborn is violation of bone integrity collarbone, most often in its middle part.

The cause of a fracture in newborns is rapid childbirth, exposure to a mechanical instrument, or the actions of a doctor.

Features of trauma in children

The main feature of this type of fracture is also called "green branch". This is due to the nature of the fracture, when the bone breaks and remains in a slightly bent state.

In this case, the second clavicle does not break, since it is held in place by the periosteum. Therefore, displacement of the broken bone will not occur, or it will be insignificant.

It often happens that the inner part of the bone breaks, but the periosteum remains to hold it. Complete displacement fractures practically never occur in newborns. Open types of fractures do not usually occur.

More severe forms of clavicle fracture, as well as the complications accompanying them are typical for older children.

Classification of clavicular fractures

Fractures can be divided into several types. Moreover, for each type characterized by the presence of its own foundation.

By quality or by the presence of damage to the skin:

1. Closed. Isolated from external environment fracture;
2. Open. The integrity of the skin is compromised, and sometimes this can cause infection.

By the number of debris and the degree of their separation:

1. No offset. For the most part, the bone tissue is preserved;
2. With offset. The connection between the fragments is broken, sometimes one of them moves quite far away.

Along the fault line and its direction:

• Oblique;
• Helical;
• Ringed;
• Transverse;
• Longitudinal.

Symptoms characteristic of injury

At the site of damage to the integrity of the bone, mild hematoma. Active movements are not broken by hand, but during palpation at the site of the bruise you may feel crunching and crackling which occurs due to crepitus.

The appearance of edema indicates that deeper layers of tissue have been damaged.

In this case, the deformation in the place where the collarbone was damaged also becomes noticeable. There may also be some limitation in the ability to move the hand.

Treatment and first aid for injury

The first step that is necessary when a clavicle fracture is detected in a newborn is immobilization.

For this purpose they use Deso bandage because it is elastic and soft. It is used to secure the child's hand to his body. In the presence of extensive hemorrhage with a bulge, which is called a cephalohematoma, intravenous vitamin K is additionally prescribed.

As a means of having an analgesic effect, it is usually chosen ointment "Traumeel S", which can also be successfully used as a remedy against edema. In addition, it can slightly increase regeneration. It is important to lubricate the entire trapezius muscle, not just the broken collarbone.

For two weeks, the newborn should not lie on the side on which the bone was broken. Treatment of a clavicle fracture in newborns after discharge continues at home. Already after 20 days the bone tissue will heal completely and this injury will not affect the child’s health in any way.

Timely first aid is half the success in treatment

Usually, a fracture of the collarbone in children is diagnosed almost immediately after birth, but sometimes it happens that such damage occurs in infants after discharge from the maternity hospital.

In this case, it is important to provide first aid on time, because a lot depends on its correctness and timeliness. You can select two ways to fix the hand in the presence of a fracture of this kind:

1. You should fold your child’s arms on his chest, first bending them at the elbow, and then place them behind his head. Next, a stick should be placed behind the back, which should be held in the elbow bends. But since not every child can for a long time If you lie there like this, it is better to use the second method.
2. It is necessary to immobilize the baby's limb, and a bandage that is not too tight is suitable for this purpose. The hand should be suspended on the scarf at a right angle.

If a baby is found to have pallor, cold perspiration, and a rapid pulse rate, we can say that he is developing all signs of vascular insufficiency.

In this case, you can give the child a little sniff of ammonia.

Afterwards, the baby should be taken to the hospital immediately.

The photo shows a Deso bandage used for a clavicle fracture in children

Anesthesia can be done through the use of special ointments, as well as through injections.

Solutions are injected directly next to the injury site so that they act faster.

Since the arm should be immobilized for the entire duration of treatment, a special type of bandage is selected that is most suitable for children. These include the following:

• Delbe rings. Also suitable for fixing displaced fractures. It consists of two rings placed on the patient’s shoulders and connected by a bandage. They tighten the shoulder blades, immobilizing the injured arm.
• Deso bandage. It is performed by fixing the arm to the chest using bandages surrounding the chest and shoulder.
• 8-shaped bandage of fixing type.
• Crutch-plaster cast.

Post-traumatic rehabilitation

Remedial measures course, aimed at quickly restoring nutrition in damaged tissue, as well as strengthening the collarbone, which has been damaged, includes the following list of measures:

• Magnetotherapy. Exposure to different frequencies magnetic field to the damaged area;
• Exercise therapy. Performing light arm exercises. Mothers can bend it slightly to the sides, carefully bend the newborn’s arm;
• Massage. It is better that it is performed only by a qualified specialist at first, since only an employee with special education will be able to select a complex that will not harm only the healed bone. In the future, you can do it yourself;
• Electrophoresis. The effect of current together with special medicine It can also have a beneficial effect and speed up the body’s recovery after injury.

Such measures are aimed at accelerating blood flow, which will promote speedy healing.

Quality therapy is important. The consequences of a clavicle fracture in newborns, if not treated in a timely manner and in the absence of a rehabilitation period, can be very severe and result in lifelong disability or stoop.

Proper nutrition

Infants who are on a natural diet and drink breast milk, as a rule, are enriched with all the necessary microelements. Since his food comes directly from his mother, she needs to pay special attention to her own diet.

It should include more of those products that will be rich in silicon and calcium, magnesium, phosphorus. Other elements that directly influence the structure of bone tissue are also important.

For children whose main diet is artificial formula, the doctor may recommend a special diet.

It is selected only individually, since the baby’s body is not yet strong enough and is not able to fully cope with infections.

Video: How to apply a Deso bandage