Clavicle Fractures: Babies & Broken Collarbones

Broken clavicles are surprisingly common. Around 1 in every 50 newborn babies will be delivered with a broken collarbone, according to Nationwide Children’s Hospital. That makes a broken clavicle the most common birth-related injury in America. In most cases, collarbones are broken during vaginal deliveries, especially difficult ones that come at the end of a lengthy labor, in which the child’s body has been subjected to hours of contractions and pressure.

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Broken Collarbones In Newborn Babies

Collarbone fractures are most likely to occur when a child is large for gestational age, which makes it more difficult for his or her body to fit through the birth canal. It can also happen because some women have narrow birth canals to begin with, inadvertently squeezing their child’s shoulders inwards toward the torso.

Shoulder Dystocia: A Serious Delivery Complication

Broken clavicles are most common, however, in cases of shoulder dystocia, when a baby’s shoulders get stuck behind the mother’s pelvis. Shoulder dystocia can be very dangerous. Children who get stuck inside the birth canal are at an increased risk for oxygen deprivation, which can lead to permanent brain damage. The priority, then, is to help the child progress down the birth canal, which often requires some repositioning.

How Obstetricians Intervene To Manage Shoulder Dystocia

Obstetricians employ numerous “maneuvers” to manage cases of shoulder dystocia, some gentle and others more invasive. McRoberts’ maneuver is usually attempted first, Medscape reports, in large part because it’s “easy to do.” The mother simply pulls her knees into her tummy and, along with gentle pressure applied to the stomach, these motions alone can be enough to free the baby’s stuck shoulder and move the delivery along.

If McRoberts’ maneuver is unsuccessful, doctors often move on to attempt manual repositioning. Very simply, these maneuvers entail reaching inside the birth canal and attempting to rotate the child out of danger. The risk for injury should be clear, and, perhaps most common, is the risk for a broken collarbone. Obstetricians must take exquisite care in attempting any maneuver to prevent harm to either the child or the mother.

Operative Vaginal Deliveries

The use of birth-assistive devices also appears to increase the risk for fractured collarbones. To speed up long and difficult deliveries, many obstetricians turn to medical instruments, most notably forceps and vacuum extractors, and perform an “operative” vaginal delivery. As in the case of manual interventions, these tools must be used very carefully, especially forceps, which are associated with a significant risk for birth injuries. One small error, one wrong move with forceps can leave a child suffering from permanent nerve damage.

What’s The Danger?

In most children, a broken clavicle will heal of its own accord over time. Babies have immature bones, softer than the bones in adults, that bounce back quickly after being damaged. The main risk of a broken collarbone is that the brachial plexus, a network of nerves that controls the arm, will be damaged, too.

Brachial Plexus Damage

The brachial plexus sits close to the collarbone, so any injuries inflicted on the clavicle can also come to affect the nerves. Brachial plexus injuries are common in children who have suffered broken clavicles. Unfortunately, these injuries can also be severe.

The brachial plexus, as we just noted, is a network of nerves. It runs from the spinal cord across the upper chest and down the arm on both sides. We have the brachial plexus to thank every time we move our arms, hands and fingers. Damage to the brachial plexus can lead to permanent paralysis or muscle weakness.

Does A Broken Clavicle Hurt My Baby?

Yes.

In most babies, a broken collarbone is first noticed because the child begins to cry, in response to the pain of their fractured clavicle. You might notice that your child has trouble moving their arms, or that they seem to experience pain (and cry a lot) when you pick them up under their arms.

To confirm a diagnosis, doctors will take an x-ray of the collarbone to analyze evidence of the break and determine its nature. If nerve damage is suspected, your physicians can perform a range of tests to understand the injury in detail. Electromyography is a simple method that uses thin needles, inserted into a muscle, to measure the amount of electricity flowing from the nerves. Magnetic resonance imaging, or MRI, can also be used to gain a picture of the nerves.

Treatment & Therapy

Most children won’t need any treatment after suffering a broken collarbone. Eventually, the bone should heal on its own, though some parents will be instructed to stabilize their child’s arm (usually by pinning their baby’s sleeve to the front of their shirt) so it doesn’t move around during the healing process. Recovery times tend to be short.

Is Every Broken Bone The Result Of Medical Negligence?

No. Sometimes babies suffer birth injuries through no fault of an obstetrician, nurse or other medical professional. Try as they might, doctors can’t prevent every birth injury. That’s true even for the most experienced, highly-educated physicians. Injuries happen; delivering children is a complex medical situation, with many risks. That’s not always the case, though. Some broken clavicles are caused by medical malpractice.

The Elements Of A Malpractice Suit

Doctors, nurses and midwives make mistakes. Some mistakes go on to cause intense suffering and severe damage. In some cases, medical professionals can be found liable for committing medical negligence, a careless disregard for the safety of patients. Medical negligence is at the core of every malpractice claim.

To prove medical negligence, your legal team will first be tasked with defining the standard of care. This is what your doctors, nurses and other medical professionals should have done under the circumstances, given your pregnancy risk factors and complications. For example, in cases when a child is very large, and may be injured by traveling through the birth canal, an emergency c-section may be the best option to preserve health.

Violating The Standard Of Care

Next, your attorneys will work together with independent medical experts to understand how your birth team deviated from the standard of care, violating accepted medical practice and broaching protocol. In our example, attempting a vaginal delivery with a very large baby may be a violation of the standard of care, given the severe risks of shoulder dystocia, oxygen deprivation and a broken collarbone.

Causation & Damages

Defining the standard of care and how it was violated is key in a medical malpractice lawsuit. Doctors who violate the standard of care are said to have been medically negligent. After determining how your medical team breached the standard of care, your attorneys will go on to prove that the violation of the standard directly caused your child’s injuries. Then your attorneys will begin to outline how your child and family were harmed by the injury, to arrive at financial damages that can be claimed in the lawsuit.

The Bottom Line

All medical professionals have a sworn obligation to provide their patients with adequate care. Doctors, nurses and hospital staff members are bound to perform their duties in accordance with the accepted standards of the medical profession, standards that can change from patient to patient. Healthcare professionals who deviate from these norms, causing harm to a patient, can be held accountable for their negligence in a civil lawsuit. All of this holds true when a child is the one who was injured.

Learn More About Filing A Lawsuit

As a parent, you may have the right to pursue a birth injury lawsuit on behalf of your child’s interests. If a doctor’s violation of accepted medical standards led to your child’s injuries, your family may be entitled to financial compensation, including damages to cover your past and future medical expenses.

Do you believe that a doctor or nurse’s mistake allowed your child to suffer harm? You need to speak with an experienced attorney immediately. You may be eligible to pursue justice by filing a birth injury lawsuit, but your time may be limited. Medical malpractice lawsuits are bound a strict statute of limitations, a state law that limits the amount of time your family has to file suit. Don’t wait to learn more. Your family has powerful legal options.

To learn more about your legal options, along with case eligibility, contact the experienced medical malpractice attorneys at Birth Injury Advocate today. Our lawyers can help. Receive a free, no obligation consultation now.