Risk factors and nursing for 70 neonates with clavicle fracture

  Objective  To investigate the related factors and nursing of 70 neonates with clavicle fracture.

  Methods  A total of 70 neonates with clavicle fracture admitted to our hospital from January 2014 to December 2018 were enrolled as observation group, another 70 neonates without clavicle fractures in the same period were enrolled as control group. The clinical data were compared between the two groups. Their risk factors and corresponding nursing intervention were analyzed.

  Results  The incidence of clavicle fracture was 0.19%(70/36 000). The clinical manifestations included crying, upper limb limitation of affected side, local swelling of affected affected clavicle, congestion, bone rubbing sound and disappearance of embrace reflex. Out of 70 neonates with clavicle fracture, the fracture was found in 5 cases during delivery, and 65 cases within 24 h after delivery, who were all confirmed by imaging diagnosis. The upper limbs were suspended by triangular towel in 58 patients with incomplete clavicle fractures, fixed by the "∞" shaped bandage in 12 patients with complete clavicle fractures. At 3 weeks after delivery, X-ray examination was performed for recheck, revealing that a large number of scab presented in fracture locations. After 1 month, they were healed and there were no abnormalities or dysfunction. There were significant differences in maternal age, maternal body mass index, delivery mode, duration of second stage of labor, umbilical cord around the neck, birth weight of neonates between the two groups (P < 0.05). Logistic multivariate regression showed maternal age (OR=1.43, 95%CI: 1.12~1.82), maternal body mass index (OR=1.42, 95%CI: 1.13~1.79), delivery mode (OR=1.42, 95%CI: 1.13~1.77), time of second stage of labor (OR=1.39, 95%CI: 1.12~1.73), umbilical cord around neck (OR=1.39, 95%CI: 1.13~1.71) and fetal birth weight (OR=1.34, 95%CI: 1.10~1.63) were independent risk factors for clavicle fracture in neonates (P < 0.05).

  Conclusion  Neonates with clavicle fracture have better prognosis. Maternal age, delivery mode, duration of second stage of labor, umbilical cord around the neck and birth weight of neonates are independent risk factors for neonates with clavicle fracture. Meanwhile, corresponding nursing measures should be taken to reduce incidence of clavicle fractures.