Broken Collarbone at Birth (Clavicle Fracture)

What is a broken collarbone at birth?

A broken collarbone at birth (a clavicle fracture) is a crack or complete break in the clavicle, the slender bone that runs between the breastbone and the shoulder, sustained by a baby during delivery. It is the most common bone fracture that happens during childbirth, and in most cases the bone heals on its own within a few weeks. The clavicle is the last bone to finish forming and sits directly in the path a baby’s shoulder must travel through the birth canal, which is why it is the bone most often injured during a difficult delivery.

Two things are true at once, and holding both is the honest way to understand this injury. Most clavicle fractures at birth are minor, heal completely, and leave no lasting harm. But a broken collarbone can also be the visible marker of the mechanical force that fractured it, and that same force can injure the nerves running just beneath it, producing Erb’s palsy or a wider brachial plexus injury. The fracture heals; a nerve injury may not.

How common is it?

Clavicle fracture is the most frequently reported birth-related fracture. Published incidence figures generally range from about 0.5% to 3% of vaginal deliveries, depending on how carefully newborns are examined; some fractures are silent and are only discovered later as a healing lump. It is far more common than a fractured humerus or any skull fracture. Its frequency is exactly why it deserves a clear, non-alarming explanation: a great many parents will encounter it, and the great majority of those babies are fine.

What causes a clavicle fracture during birth

A newborn’s collarbone breaks when force is transmitted across the shoulder during delivery. The recognized contributors include:

• Shoulder dystocia: when the baby’s shoulder becomes lodged behind the mother’s pubic bone after the head delivers. This is the single most important association, and it links the clavicle to a family of more serious injuries. See our guide to shoulder dystocia.
• Large birth weight (macrosomia): a bigger baby has broader shoulders and a tighter fit.
• Instrument-assisted delivery: forceps or vacuum extraction that adds traction.
• Breech or difficult positioning requiring manipulation to deliver the shoulders.
• Prolonged or rapid labor that changes how the shoulders navigate the pelvis.

None of these automatically means anyone did something wrong. But each is a known risk factor that a delivery team is expected to anticipate and manage.

Signs and symptoms

• The baby does not move one arm freely, or cries when that arm is moved or the shoulder is touched
• A reduced or absent Moro (startle) reflex on the affected side
• Swelling, tenderness, or a “crackling” feeling (crepitus) over the collarbone
• A firm bump appearing over the bone about a week later as a healing callus forms

Some fractures cause no obvious symptoms at all and are found incidentally. An X-ray confirms the diagnosis. Importantly, an infant who does not move an arm should also be evaluated for nerve injury, because the two can occur together and are treated very differently.

Healing timeline

Newborn bone heals quickly and remodels almost perfectly. A typical course:

Newborn clavicle fractures almost never need surgery, casting, or a formal brace. Treatment is comfort and gentle handling. Full, normal healing is the expected outcome.

When a broken collarbone signals excessive force

Here is where a common, usually-benign injury becomes legally meaningful. The clavicle can break as an unavoidable event even under careful delivery. But it can also be the fingerprint of excessive downward traction on the baby’s head and neck, the same maneuver that overstretches the brachial plexus. That is why the association that matters most is not the fracture itself but what accompanies it:

• A clavicle fracture plus arm weakness or a limp arm suggests the force reached the nerves, an Erb’s or Klumpke’s palsy pattern.
• A fracture after a documented shoulder dystocia raises the question of how that emergency was managed.
• A fracture with other injuries (facial marks, a humerus fracture) points to the amount of force applied.

An isolated clavicle fracture in an otherwise normal newborn is usually not evidence of negligence. A clavicle fracture bundled with nerve injury after a mismanaged shoulder dystocia can be.

Was it preventable?

Not every broken collarbone at birth is malpractice. Many happen despite appropriate, skillful delivery and are the price of getting a stuck baby out safely: a fracture is far preferable to oxygen deprivation. The standard of care asks a narrower question: were the risk factors (a large baby, gestational diabetes, a prior shoulder dystocia) recognized, was the shoulder dystocia managed with recognized maneuvers rather than brute traction, and were accompanying injuries promptly evaluated? When the answer is that excessive force was used where a controlled maneuver was called for, the same event that broke the bone may also have caused a preventable nerve injury.

Legal options for families

A clavicle fracture on its own rarely supports a malpractice claim, because it usually heals fully and often occurs without negligence. The cases worth reviewing are those where the fracture signals something more: a brachial plexus injury, a shoulder dystocia that was managed with excessive traction, or a delivery whose known risks were ignored. Compensation in those cases addresses the lasting nerve injury rather than the healed bone: therapy, surgery, and long-term function.

Deadlines to file (statutes of limitations) vary by state and are explained in our state-by-state statute of limitations guide. Where a case is handled depends on where the birth occurred: Banville Law attorneys are licensed in New York and Washington, D.C.; The Weitz Firm attorneys are licensed in Pennsylvania and New Jersey; elsewhere, the alliance connects families with its vetted network of local birth injury attorneys. Families in New York can start with our New York birth injury guide.

Frequently asked questions

Will my baby’s broken collarbone heal completely?

Almost always, yes. Newborn clavicle fractures heal on their own, usually within three to six weeks, and remodel so completely that the bone typically looks normal afterward. Surgery and casting are essentially never needed.

Is a broken collarbone at birth a sign of malpractice?

Usually not by itself. It is the most common birth fracture and often occurs without any error. It becomes a reason to review the records when it is paired with nerve injury (a weak or limp arm), follows a shoulder dystocia, or accompanies other signs of excessive force.

What is the lump on my baby’s collarbone?

That firm bump, appearing about one to three weeks after birth, is a healing callus, a normal and expected part of bone repair. It gradually smooths away over the following months.

My baby isn’t moving one arm. Is that just the fracture?

It might be: a baby may guard a painful arm. But a limp or weak arm can also mean a brachial plexus nerve injury, which is a different and more serious problem. Any infant not moving an arm should be evaluated for both.

Sources

This page is for general education and is not medical advice. Medical facts above are drawn from the cited primary sources; legal statements reflect the reviewing attorneys’ professional experience. Always consult your child’s physician about medical concerns.