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Childbirth is a complex and unpredictable process, during which both the mother and her baby can suffer. Birth injuries in newborns are not so rare in practice. The most common of them is considered to be a fracture of the collarbone of a newborn - approximately 2-3 children out of 100 have to learn from their own experience what it is on the first day of life.

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Causes of clavicle fracture in newborns

The clavicle is a paired bone in the human body. During childbirth, the right clavicular bone is most often injured, which is associated with the peculiarities of the position of the child during his birth. There are several immediate reasons that can lead to disruption of the integrity of this bone:

Too much pressure from the female pelvis on the baby during childbirth. This becomes possible in the event of a discrepancy between the size of the fetus and the pelvis of its mother.
Anatomically incorrect position of the child during childbirth also leads to excessive compression of the clavicle bone and increases the risk of injury. This happens during rapid labor, when the baby does not have time to make all the necessary turns and take the correct position, as well as when the fetus is presented incorrectly (gluteal, leg, facial, transverse).
Mechanical damage due to manual and instrumental methods of obstetrics. In the case of complicated births, so-called obstetric aids are often used, the purpose of which is to facilitate the birth of the child. For example, if a baby's shoulders get stuck during labor, the doctor may manually cut the collarbone so that the baby can be born.
A genetic disorder called osteogenesis imperfecta can also cause bone damage in a newborn.

Summarizing the above, risk factors for damage to the clavicular bone in a newborn are:

narrow pelvis of the woman in labor and large fetus;
childbirth with complications;
dystocia (stuck) shoulders during childbirth;
genetic abnormalities in the child.

Characteristic features of a fracture in children

Fractures of the clavicle are divided into open and closed (depending on the presence of damage to the muscles and skin), with and without displacement (depending on the relative position of the individual parts of the broken bone), the middle part of the clavicle or its ends.

Due to the extreme flexibility of the bones of newborn children, their collarbone fracture is most often uncomplicated: the bone does not break completely and is bent at a slight angle. At the same time, the periosteum remains practically intact, which guarantees the absence of displacement and fragments. This type of fracture is also called a “green branch”, based on its characteristic features.

Signs of a clavicular fracture

Diagnosis of this injury in a newborn is not difficult and is based on the presence of the following signs:

change general condition infant: fussiness and crying (especially during swaddling or bathing), refusal to eat and weight loss;
there may be slight bruising and swelling in the collarbone area;
limited movement of the arm on the side of the fracture, in more severe cases – pseudoparalysis of the arm;
When palpated, a pathological location of the clavicular bone is felt, and a slight cracking sound may be heard.

In rare cases, a clavicle fracture is diagnosed only at the stage of callus formation, that is, several days or even weeks after the injury. Therefore, if you suspect this pathology, you should contact a pediatric surgeon. The most informative diagnostic method is radiography.

First aid

After birth, each child is examined by a neonatologist who will provide qualified emergency assistance in the presence of any birth trauma. But if the diagnosis of a “clavicle fracture” was not made on time in the maternity hospital, but was suspected by the baby’s parents later, then first aid for the child consists of:

ensuring the immobility of the injured arm: to do this, hang the limb at a right angle on a scarf attached to the neck;
immediately go to the hospital.

Treatment and rehabilitation

As a rule, treatment of this injury in newborns does not require surgical intervention and is conservative.

The affected arm is tightly bandaged to the body for 5-7 days. Plastering of newborns is not practiced.

Important: you need to make sure that when bandaging your hand, you place a small soft cushion in the baby’s armpit, and that while wearing the bandage, the child’s fingers do not turn blue - this means that the bandage is too tight.

If there is a hematoma in the clavicle area, Traumeel S ointment is prescribed, which has an analgesic and decongestant effect.

Important: the ointment is applied not only at the site of injury, but also towards the back of the neck and shoulder blade.

In the presence of severe pain, analgesics are administered intravenously.

Important: if the child’s pain is so severe that it requires the administration of painkillers, this indicates the severity of the injury - it may be necessary to seek repeated consultation with a surgeon to exclude the development of complications.

Physiotherapy is very effective both at the treatment stage and at the rehabilitation stage of a child with a broken collarbone. Electrophoresis, magnetic therapy of the injured area, and physical therapy (performing gentle bending and bending of the child’s arm) are used.

Important: performing physical therapy exercises must be approved by a doctor.

As a rule, with a competent approach to treatment, the fracture heals within one and a half to two weeks and does not leave undesirable consequences in the form of:

the addition of a secondary infection in a complicated or late diagnosed fracture;
formation of a false joint on the collarbone;
damage to nerves and blood vessels.

Despite the fact that a timely identified clavicle fracture in a newborn heals quickly, it is necessary for parents to ensure competent rehabilitation period within 2-3 weeks after discharge from the hospital:

within 2 weeks after removing the bandage, the child should not lie on the injured side;
Tight swaddling is recommended;
carry out physiotherapeutic procedures: massage, therapeutic exercises, electrophoresis;
With food, the child must receive the necessary amounts of microelements that promote bone tissue regeneration (phosphorus, calcium, silicon).

The most important thing for parents of a child with a broken collarbone is to remember that panic and self-medication are inappropriate in this case. Qualified medical care provided on time eliminates everything Negative consequences this birth trauma.

Sometimes a child has a broken collarbone confused with a severe bruise, which is why timely help does not happen, and his condition worsens.

This is why it is so important to recognize the injury and provide all the necessary help.

If they reacted in time, then the fracture will heal quickly and without consequences, and such a temporary pathology will not cause any discomfort to the child in the future.

What are the consequences of cephalohematoma in newborns? find out right now.

Concept and characteristics

What happens?

Along the fracture line of the bone, these fractures are transverse, longitudinal, and also distinguish splintered, oblique, helical. Depending on the condition of the skin, clavicle fractures can be closed or open.

According to the degree of separation of bone fragments:

without bone displacement;
with bone displacement (a fracture can be incomplete or complete when the connection between the fragments is completely broken).

If the fracture is open, the child will have to be operated on. If help is not provided in a timely manner, blood poisoning may occur.

When closed fracture X-rays will help determine the diagnosis accurately.

Causes

Indirect trauma usually causes a fracture in childhood - either squeezing the chest or falling on the handle.

Typically, the location of the fracture is the border of the outer and middle particles of the clavicle, because in this area the bone is thinner and the curvature of the bone is more pronounced.

Direct trauma much less common- this happens in the external clavicular part.

Broken collarbone in newborns occurs due to:

Rapid labor, when the fetus does not have time to take the desired position in order to correctly pass through the birth canal.
Narrow internal pelvis of the mother.
Incorrect fetal inversion (manual or using instruments) by the doctor.
The size of the fetus, which does not correspond to the parameters of the birth canal.
Buttock position of the baby in the uterus.
Brittleness of the baby’s bones due to genetic pathologies.

It is indeed not so rare for newborns to have a clavicle fracture during childbirth. This is due to the anatomical softness of the baby’s bone tissue and complicated childbirth.

But the child is pretty recovers quickly after this birth trauma.

Symptoms and signs

Pain syndrome with this injury it is not very pronounced.

There may be moderate swelling and bruising at the site of injury.

Often parents believe that the child was simply hurt, and they go to the doctor only when a formation has formed at the site of the injury. noticeable bone callus.

Sharp pain is characteristic of a complete fracture. On the side of the fracture, the shoulder girdle appears shortened. The child tilts the body to the injured side, holds the sore arm, and presses it to the chest or tummy.

If a fracture occurs in a child who is still can't express his complaints, then you can see the pathology:

by the restless crying of a child when light pressure is applied to a broken bone;
by the absence of a bulge in the fossa above the collarbone;
by and swelling of soft tissues in the injured area;
by characteristic sounds when moving the hand;
due to restrictions in hand movement and bone calluses (in some cases).

If you notice even just one alarming sign, you need to see a doctor. This could be a surgeon or traumatologist. A visual examination or x-ray will provide an accurate diagnosis.

How to distinguish from a bruise?

No way - do it only a doctor can do this.

General symptoms will not allow parents to accurately determine the nature of the injury. Aching pain, swelling, and hematoma occur in both cases.

Because there must be symptoms reason to urgently consult a doctor so that assistance is adequate and timely.

Features of a displaced fracture

This type of fracture has more severe symptoms. Damaged hand visually it seems sicker than healthy. Externally visible fragments of bones that stretch the skin. With such a fracture, a child instinctively presses the hand to the body, supporting it by the forearm.

The displacement can be complete when the bone fragments are not supported by the periosteum. When the displacement is incomplete, parts of the bones are held back by the periosteum. Displaced fractures are more difficult to heal.

In particular, treatment will be difficult if nearby tissues, vessels and nerves are damaged.

First aid

Call a doctor - this is the most correct and only correct thing for sure will not harm the child. Otherwise, it’s easier to say what not to do.

If for some reason the parents discover an injury to the newborn’s collarbone at home, they should take a piece of tissue, fix the arm bent at the elbow scarf bandage. It is attached to the neck; such a bandage should under no circumstances put pressure on the baby’s body.

If you cannot do this or are simply afraid, wait until the doctor arrives.

Diagnostics

To confirm the diagnosis, the doctor will order an x-ray of the collarbone in a straight position. Usually there are no difficulties in making a diagnosis. Sometimes required CT scan or even an MRI collarbone.

If there is any suspicion of vascular damage, a consultation with a vascular surgeon will be required. In rare cases, there may be a rupture of the lung, which is detected on an x-ray.

You can find information on treating dehydration in a child on our website.

Treatment regimen and fixation options

Give your child something to drink before the doctor arrives. Nurofen(once) in an age-appropriate dosage.

Tell your doctor about taking the drug.

It is necessary to ensure complete rest for the handle, at the site of a possible fracture. You can put an ice pack. If the fracture is open, the bleeding must be stopped with a pressure bandage.

Fixation methods:

Deso bandage- applied for a week or 10 days, provides peace to the hands of children under 3 years of age.
Delbe rings- a means for immobilizing the limbs of children over 3 years old, these are two cotton-gauze rings that are tightened on the back with a rubber tube.
Eight-shaped fixing soft bandage - shaped like a figure eight, its ends are fixed on the back, such a bandage allows you to keep fragments of the collarbone from moving.
Plaster rigid bandage - holds bone fragments in the correct position, applied only with preliminary anesthesia.

The following therapeutic structures can also be applied - Kuzminsky splint, Beler splint, Rakhmanov splint, special corsets and bandages.

The doctor suggests the optimal type of fixation structure that is suitable for a specific child with a specific injury.

How are broken bones treated in newborns?

Such injuries in infants heal quickly - a cast, and even more so, surgery needed extremely rarely.

If the collarbone is fractured, the baby's limb must be immobilized; in this case, a Deso bandage is often used.

A cotton swab is inserted into the armpit area, the handle is bandaged to the body, only the bandage should not be tight.

The fracture heals within a week, but the handle is fixed for another month so that its functionality is fully restored.

The baby should sleep only on your back or the healthy side, and you need to feed him only on the healthy side. During the entire treatment period, the child is visited by a doctor who monitors the baby’s recovery.

Surgery

The operation, if indicated for the child, is safe and effective. Complications occur in only 1% of patients.

Operation is needed in case of:

open fracture;
severe displacement, when it is impossible to combine the fragments;
comminuted fracture;
damage to organs - lung, nerves or blood vessels.

Performing an operation under general anesthesia. Today, bone can be restored using special plates, screws or pins.

The child can move his arm already on the second or third day, and the bandage is removed after two weeks.

Rehabilitation period

The doctor will prescribe measures post-traumatic rehabilitation.

This can be magnetic therapy, physical therapy, massage, electrophoresis.

A necessary condition for recovery- proper nutrition. Of course, if we are talking about a baby, then physical therapy his mother will work with him, and better nutrition there will be breast milk for him.

Consequences and forecasts

If you react competently and quickly, the bones will heal without complications in a short period of time. If the child's immunity is weakened, the fracture site infection may occur.

Sometimes a false joint is formed if the bone was not fixed correctly, or the fracture was accompanied by severe displacement.

If your child is in severe pain, the doctor will prescribe analgesics. They are administered intravenously, and such treatment is only possible in a hospital.

But usually the fracture heals quickly, without complications, and the injury does not bother the child later. If this birth injury, then the doctor will tell you how to care for the baby, how to handle him correctly during the days of treatment.

The child should be shown to a doctor in a timely manner to monitor how the fracture heals and the functionality of the handle is restored.

You can learn about a clavicle fracture in a newborn child from the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Women who find out about their pregnancy for the first time have many questions. Expectant mothers are interested in how their growing belly should be, hard or soft. The changing of its shape and structure is affected by the growing uterus.

Abdominal changes during pregnancy

The uterus begins to enlarge almost from the first days after conception. However, initially the woman does not notice these changes. Until approximately the 8th week of gestation, the uterus is not felt at all. In this regard, the walls abdominal cavity remain soft.

Toward the middle of the second trimester, the bottom of the reproductive organ begins to rise above the pubic bone. The expectant mother, despite the fact that the belly is not yet noticeable to others, may feel compaction.

The uterus protects the baby throughout the entire gestation period. If there is a risk to the life of the fetus, the walls of the organ may shrink. This phenomenon is called “tone”. Tension of the uterus can be observed several times a day. But in most cases the stomach remains soft.

The consistency of the uterus also depends on genetics. A woman can go through almost the entire 9 months with a moderately hard belly. And this will not be a pathology if there is no pain. But if the stomach becomes too hard to the touch, nagging pain or bloody issues, you must seek medical help immediately. This is especially dangerous on early stages pregnancy. A hard belly may signal the onset of spontaneous abortion.

The consistency of the uterus changes depending on the position of the woman. When the expectant mother rests, the muscles relax. The abdomen remains soft, regardless of the period. During walks, the uterus becomes firmer.

The abdomen may become firmer as the bladder fills. The uterus tightens so that neighboring organs do not infringe on the fetus, and it has enough space for full development. Tone is also observed when the intestines are full. A pregnant woman is not recommended to overeat.

After 30 weeks, pregnant women notice the appearance of training contractions. The uterus periodically comes to tone. In this way, the organ prepares for the upcoming birth. This condition is not considered pathological. But if the stomach contracts at regular intervals and there is nagging pain, it is possible that labor has begun. It's worth seeing a doctor.

When tone is dangerous

Regardless of whether the belly is soft or hard in the early stages of pregnancy, you need to register in a timely manner. The doctor examines the expectant mother and rules out possible pathologies, will order tests. You can’t put off a visit to the gynecologist if you have pain in your lower abdomen and a pregnancy test shows two lines. Timely seeking help will help prevent miscarriage.

In a healthy woman, uterine tension is observed only periodically. If the stomach is constantly toned, this can lead to disruption of the blood supply to the fetus, premature placental abruption, and spontaneous abortion.

Unfortunately, increased uterine tone is a common pathology of pregnant women. This diagnosis is made in 65% of cases. The likelihood of developing pathology in women over 35 years of age increases significantly. Expectant mothers who work in hazardous industries, eat poorly, and do not follow a daily routine are at risk.

Physiological reasons (for example, sexual intercourse) can provoke contraction of the muscles of the uterus. Therefore, with the development of uterine tone, a woman is advised to avoid excessive physical activity and sexual intercourse.

The tone of the reproductive organ in early and late pregnancy often increases due to hormonal imbalance. The problem often occurs in women with increased content androgens and progesterone deficiency.

Compression of muscle fibers will be observed against the background of overstretching of the walls of the uterus. The organ rapidly enlarges, the muscles begin to contract reflexively. This condition is observed in women with multiple pregnancies or polyhydramnios. Anomalies in the structure of the organ can also provoke the development of a pathological process.

Alarming symptoms

Ask for help to the expectant mother should be used for any unpleasant signs. ABOUT increased tone uterus will indicate discomfort in the pelvic area, nagging pain in the lower abdomen, increased hardness of the abdominal wall. The localization of discomfort will depend on the duration. In the first weeks of pregnancy, discomfort is felt closer to the pubic bone. As the uterus grows, the area of pain will increase.

Starting in the middle of the second trimester, the hard uterus can be easily felt through the abdominal wall. Against the background of organ compaction, expectant mothers have an increased urge to urinate or defecate. Fetal movements may also increase. The child feels uncomfortable in the contracted womb.

The pain threshold for all women is different. Therefore, unpleasant sensations with uterine tone are not always observed. Sometimes a woman does not pay attention to a slight tingling sensation in the pubic bone. As a result, a slight tone develops into a threat of termination of pregnancy.

Hospitalization is needed if:

cramping pain appears in the abdomen;
against the background of hardening of the abdominal wall, bloody discharge is observed;
the nature of the fetal movements has changed (the child began to move chaotically);

The expectant mother should be able to listen to her feelings. Abdominal tension is a reason to consult a gynecologist.

What to do if your stomach becomes hard

Treatment tactics are chosen according to the severity of the pathological process. If there is slight tone of the uterus, it is enough to reconsider the daily routine, rest more, limit physical exercise. You should avoid foods that cause flatulence.

If the tone is pronounced, the woman is hospitalized in the gynecological department. Therapy is carried out aimed at relaxing muscle fibers. To normalize the condition reproductive system drugs from the following groups are prescribed:

Antispasmodics. Lead to a decrease in smooth muscle tension. With their help, it is also possible to eliminate pain caused by tone.
Sedatives. They calm a pregnant woman and help overcome the fear of losing the fetus. With a slight increase in tone, herbal remedies are more often prescribed. At severe conditions Tranquilizers may be used.
Tocolytics. Lead to inhibition of the contractility of the reproductive organ.

If uterine tone is caused by a lack of progesterone, hormone replacement therapy will be prescribed.

During pregnancy, a woman feels a change in the consistency of her abdomen. The uterus either hardens or becomes soft again. This is normal if you feel good. If you feel alarmed, you should seek medical help. Proper treatment of uterine tone will avoid complications for mother and child.