Bone Injuries at Birth

Common Causes

Bone injuries in newborns often happen during birth, especially in situations like 

  • breech delivery (when the baby is positioned feet-first) 
  • shoulder dystocia (when the baby’s shoulder gets stuck during delivery). 
  • Babies with a higher birth weight are more at risk.

Clavicular Fracture (Broken Collarbone)

  • Most Common Bone Injury: 
    • The clavicle, or collarbone, is the most frequently broken bone in newborns during birth. 
    • This type of fracture is often an unpredictable and unavoidable part of a normal delivery.
  • Associated Factors: 
    • Factors that increase the risk include
      • a high birth weight
      • the use of forceps during delivery
      • shoulder dystocia 

Symptoms

  • The baby may show signs of “pseudoparalysis,” where they avoid moving the arm on the affected side. 
  • You might also notice a grinding sensation (crepitus), an uneven feel to the bone, or muscle tightness in the neck area.

Diagnosis

  • An X-ray is used to confirm the fracture.

Treatment Options

  • The clavicle typically heals within 7-10 days. 
  • To reduce pain, the baby’s arm movement can be restricted by pinning their sleeve to their shirt. 
  • It’s important to also check for other potential injuries, like those to the spine, brachial plexus (nerves in the shoulder area), or upper arm bone (humerus).

Long Bone Fracture (Arms and Legs)

  • Early Signs: 
    • If a newborn has a broken arm or leg, they may stop moving the affected limb.
    • Swelling and pain when the limb is moved are also common signs. 
    • Sometimes, the doctor might hear or feel a snap during delivery, indicating a fracture.
  • Diagnosis: 
    • An X-ray of the affected limb is used to confirm the break and to make sure it’s not a case of joint infection (septic arthritis).
  • Treatment: 
    • Broken bones like the femur (thigh bone) or humerus (upper arm bone) are usually treated with a splint. 
    • If the bone is displaced (out of place), a procedure to realign and cast the bone might be necessary. 
    • Recovery typically occurs in 2-4 weeks, with callus (new bone) formation visible within 8-10 days, at which point immobilization can often be stopped.
    • Consultation with an orthopedic specialist is recommended.

Epiphysial Displacement (Growth Plate Injury)

  • What It Is: 
    • This injury occurs when the growth plate, which is the soft area of cartilage at the ends of long bones, separates from the bone. 
    • This can happen in bones like the humerus (upper arm) or femur (thigh).
  • Symptoms: 
    • The baby may have 
      • swelling around the shoulder
      • a grinding sensation (crepitus)
      • pain when the shoulder is moved
      • The arm may lie limp by the side, and movement is painful.
  • Diagnosis: 
    • The growth plate in the upper humerus is not visible on X-rays at birth, but new bone (callus) will appear within 8-10 days and can be seen on X-rays.
  • Treatment: 
    • The arm is typically immobilized for 8-10 days. 
    • Fractures near the end of the bone (distal epiphysis) are more likely to result in long-term deformities compared to those near the upper part (proximal epiphysis).

Bone Injuries at Birth

If you notice any unusual symptoms in your baby, such as those listed above, contact your pediatrician immediately. Early detection and treatment are crucial for the best outcomes.

While not all birth injuries can be prevented, certain risk factors can be managed with proper prenatal care, careful monitoring during labor, and skilled medical intervention when necessary.

The prognosis depends on the type and severity of the injury. Many babies recover fully with appropriate treatment, while others may require ongoing care. Our team at Gertrude's Children's Hospital will provide you with detailed information about your baby’s condition and expected outcomes.

Surgery is only recommended when necessary and is performed by experienced pediatric surgeons. Your baby’s safety and well-being are our top priorities, and we will discuss all potential risks and benefits with you before proceeding.

Following the treatment plan provided by your healthcare team is essential. This may include exercises, feeding practices, and regular follow-up visits. Our team will guide you on how to care for your baby at home and provide resources for additional support.

Contact Us

If you have concerns about your newborn’s health or if your baby has been diagnosed with this birth injury, we encourage you to schedule an appointment with one of our specialists at Gertrude’s Children’s Hospital. Early intervention is crucial, and our team is here to help.

Contact us today to learn more about our Bone Injuries at Birth treatment options.

Book Appointment