Who is to blame for a clavicle fracture found at birth?

time:2022-12-09 05:50:05source:monlittlebaby.com author:Diet
Who is to blame for a clavicle fracture found at birth?

*Only for medical professionals to read and reference. Do a good job of prenatal care and reduce the occurrence of clavicle fractures. The clavicle, commonly known as the "Beauty Bone", is an S-shaped curved slender bone. It is located under the skin and is the boundary between the neck and the chest. It is the only bony connection between the upper limb and the trunk. It can maintain the normal position of the shoulder joint and increase the activity of the upper limb. scope and improve labor efficiency. The large blood vessels and nerves that distribute to the upper extremities pass behind the middle of the clavicle. The clavicle plays an important role in human image and function. What would happen if the baby was born with a broken clavicle? Neonatal clavicle fractures are the most common type of obstetric fractures. Sometimes the symptoms are not obvious, and they are easily ignored by doctors or parents when they are born. The author has also encountered this phenomenon in my work, and listed 3 typical cases: Case 1: About 2 weeks after the baby was born, after the mother was breastfeeding, she inadvertently touched the right clavicle and felt a hard lump. She quickly touched the left side, which was smooth and smooth. Go to the hospital quickly, X-ray shows the right clavicle fracture, callus formation. Source: Case 2 of Shenzhen's major event: a huge child, refused cesarean section, and delivered vaginally. Shoulder dystocia occurred during the production process, and the mother was under-productive. After active treatment by obstetricians and midwives, the newborn was delivered. Immediately after the occurrence of shoulder difficulty, the bilateral clavicle was examined, and the clavicle was palpated from the outside to the inside. The right side was palpable and the child was crying, and the fracture was considered. Case 3: Full-term vaginal delivery, birth weight 3.5kg, acute delivery, no asphyxia. After birth, the baby sleeps less, cries paroxysmal, is not easy to comfort, cries shrill, and is irritable. She was admitted to the hospital for reasons of crying. A transverse fracture of the right clavicle with displacement was diagnosed during the exclusionary examination. Source: Netease @Code Farm uncle, what were the reactions of the parents of the three babies when they learned that the clavicle was fractured? Case 1: Because the callus has been formed and the baby has no special performance, the parents are worried that the baby's shoulders will be high on one side and low on the other side when the baby grows up, which will affect the appearance. After being explained and appeased, he went home for follow-up. Case 2: The prenatal doctor repeatedly communicated about the possibility of birth injury due to insisting on choosing natural birth, and the shoulder dystocia occurred during the production process. Although the clavicle was fractured, the family not only understood it very well, but also thanked the doctor for the timely treatment, which did not cause the child to have more serious consequences. Case 3: I heard that the baby's crying after birth was caused by a fracture during the production process. It is unacceptable that the child will have fractures. He insisted that the doctor broke the bone in a rude manner during delivery, and determined that it was a medical malpractice. Ask the hospital for compensation and be responsible for the baby's future health. So, why does a pregnant woman have a neonatal clavicle fracture during the production process, how to find it early, how to deal with it, whether it will leave sequelae, whether it is a medical malpractice, should you claim it?

1Why do newborn clavicle fractures occur during childbirth?

Neonatal fractures are the most common birth trauma fractures. According to literature reports, the incidence of neonatal clavicle fractures in the United States is 0.4%, and the incidence in my country is about 0.46%. The clavicle is slender and curved, and the lordosis of the medial 2/3 and the posterior-superior bulge of the lateral 1/3 are relatively fragile and prone to fractures. Clavicle fractures are related to birth weight and are mostly caused by shoulder dystocia. They often occur in overweight and difficult-to-deliver babies, but they can also occur in natural and cesarean sections. When the fetus is delivered, the body position drops rapidly, and the front scapula that comes out first squeezes into the pelvic pubic symphysis of the parturient, and the clavicle is extremely bent and fractures occur. Clavicle fractures mostly occur in the center or the middle and outer 1/3, which are transverse fractures with displacement and incomplete fractures (greenstick fractures). The incidence of fractures on the left and right sides is similar, and most of them are unilateral. 5% of neonatal clavicle fractures with brachial plexus injury.

2How to detect clavicle fracture early?

It is difficult to detect the initial symptoms of clavicle fractures in neonates, but careful observation and physical examination of neonates with high-risk factors can still reveal clues, such as: 1) The infant is reluctant to move the upper arm on the affected side or exercise Inflexibility, or complete loss of exercise ability; 2) When doing passive activities on the upper limbs on the injured side, infants often cry, especially in the injured area, they will cry constantly when touched; 3) When the clavicle is touched, bilateral asymmetry can be found , the clavicle in the affected area has a thickening and fuzzy feeling; 4) The movements of the upper limbs on both sides are inconsistent, and the upper limb on the affected side may be painful due to pain. The limbs are close to the chest, and the head is turned to the opposite side; Induration can be felt in the later stage, which is the formation of callus.

3How to deal with it? Will there be any sequelae?

Clavicle fractures in newborns are not terrible and generally do not require special treatment. Due to the strong plasticity of the bones of the newborn, if the position is still good, the periosteum and callus are generally formed in 7 to 9 days, and they can heal themselves in a month. It will disappear with no sequelae. 4 The most sensitive question is, is the fracture of the clavicle of the newborn a medical malpractice? Does the hospital need to compensate? Medical malpractice needs to meet the following constituent elements: 1. The main body of medical malpractice is legal medical institution and its medical staff; 2. Medical institution and its medical staff violate the laws and regulations of medical and health management and the norms and routines of diagnosis and treatment; 3. Medical The direct perpetrator of the accident has subjective negligence in diagnosis and treatment; 4. The patient has personal injury consequences; 5. There is a causal relationship between the medical behavior and the injury consequences. Childbirth is an extremely complex process. Whether it is natural childbirth or cesarean section, there may be neonatal birth injuries due to dystocia or surgical operations. Clavicle fractures are the most common type of obstetric trauma fractures, which are incapable of being delivered during childbirth. Predicted and unavoidable complications. There are many causes of clavicle fractures in newborns, the most common being problems of the birth canal, too large fetus, shoulder presentation, abnormal fetal position, etc. Of course, the unskilled operation of medical staff is also one of the reasons, but it is not the main factor. Vaginal delivery of a child requires the help of medical staff. In this process, the head, shoulders, abdomen and limbs of the fetus need to be squeezed through the birth canal. When the pregnant woman exerts force, the medical staff also needs to assist the delivery. Therefore, when some children are born, there may be scalp hematomas, and even clavicle fractures. The alignment of the clavicle is also the lowest requirement among all fractures in the whole body. As long as the broken ends of the fractures are held together, they can grow well. It does not require how tight the alignment is, how well the anastomosis is, and there will be no sequelae. Therefore, the occurrence of neonatal clavicle fractures and medical malpractice are not a concept. Moreover, the prognosis of neonatal clavicle fracture is good, no special treatment is required, and no sequelae will be left. The antenatal doctor will also inform about the complications of childbirth and obtain the signed consent of the family members. Even in developed countries such as the United States, the incidence of the disease is similar to that in China. Therefore, even with the best obstetric care, the occurrence of birth injuries cannot be avoided. It is of little significance to file a lawsuit against the doctor simply because the clavicle fracture occurred during the birth of the newborn. How to prevent clavicle fractures in newborns? The prevention of clavicle fractures in neonates is to do a good job of prenatal care, so that obstetricians can fully grasp the situation of the fetus in the uterus, including weight, head circumference and fetal position. Appropriate judgment is made about the mode of production to minimize the incidence of birth injuries. Cesarean section for overweight infants can also help reduce the incidence of clavicle fractures. During the healing period of the baby, it is recommended that parents adopt the correct way to hold the baby in daily care, so that the baby will not be injured twice during the healing process of the baby. When the baby is in severe pain, give the child an analgesic or ice compress. The ice compress is usually applied every 2 to 3 hours every day, and each time lasts 15 to 20 minutes. References: [1] Qiu Xiaoshan, Ye Hongmao, Shao Xiaomei. Practical Neonatology. Fifth Edition. [2] Regulations on Handling Medical Malpractice (2002 edition). Yu You want to see the Pediatric Clinical Knowledge Doctor Station App. The medical community strives for the accuracy and reliability of its published content when it is approved, but does not make any commitments and guarantees for the timeliness of the published content, and the accuracy and completeness of the cited materials (if any), and does not assume any responsibility for the any liability arising out of the date of the content, possible inaccuracies or incompleteness of the material cited. Relevant parties are requested to check separately when adopting or using it as a basis for decision-making.
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