Research Article
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Yenidoğan klavikula kırıkları ve ilişkili risk faktörlerinin değerlendirilmesi

Year 2024, Volume: 4 Issue: 2, 56 - 60, 22.08.2024
https://doi.org/10.58961/hmj.1527869

Abstract

Amaç: Antenatal dönemde yenidoğanda ortaya çıkan fiziksel yaralanmalar “doğum travması” olarak belirtilmektedir. Klavikula kırıkları yenidoğanlarda kemiğe bağlı en sık görülen doğum travmasıdır. Çalışmamızda yenidoğan muayenesinde klavikula kırığı saptanan olguların değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Hastanemizde 1 Ocak 2022 ile 1 Ağustos 2024 tarihleri arasında doğan bebeklerin dosyaları retrospektif olarak incelendi. Çalışmamızda belirtilen 2,5 yıllık zaman aralığında hastanemizde doğum sayısının 2756 olduğu (2022:1185,2023:1044,2024:527) tespit edildi. Bu doğumların içerisinde klavikula kırığı tespit edilen 31 yenidoğan hasta çalışmaya dahil edildi.
Bulgular: Toplam doğumların %42,6’sı normal spontan vajinal yol ile olurken %57,4’ünün sezaryen yöntemi ile olduğu tespit edildi. Çalışmamızda olguların kız/erkek oranı 13/18 idi. Olguların anne yaşı ortalaması 26,64 ± 4,61 gebelik haftası ortalaması 39,08 ± 1,04 idi. Doğum şekli değerlendirildiğinde normal vajinal doğum ile doğan 29 (%93,5), sezaryen ile doğan 2 (%6,5) olgu saptandı. Çalışmamızda doğum tartısı en az olan olgu 2770 gr iken en fazla doğum tartısına sahip olgu 4640 gr’dı. Olguların doğum ağırlığı ortalaması 3462,25 ± 453,11 gr saptandı. Klavikula kırığı saptanan olgularımızın %93,5’i (n:29) vajinal yol ile dünyaya gelirken, %6,5 ‘inin (n:2) ise sezaryen ile doğduğu saptandı.
Sonuç: Çalışmamızda tüm doğumların %1,1’inde klavikula kırığı saptandı. Ayrıntılı yenidoğan muayenesinde klavikula kırığı şüphesi olan hastalarda direk grafi ile tanı konmaktadır. Genellikle konservatif yaklaşım ile sekelsiz iyileşme olmaktadır. Doğum travmasının şiddetine bağlı gelişen sinir hasarı varlığında uzun dönem takip ve komplikasyonlar görülebilmektedir.

References

  • Silahlı N.Y., Öz N.Z. Doğum sürecinde gelişen yenidoğan üst ekstremite kırıklarının klinik özellikleri. T Kadın S Neonatol Dergisi 2023; 5(1): 1-5.
  • Phuengphaeng A, Sirisomboon R. Incidence and Risk Factors of Major Neonatal Birth Injuries in a Tertiary Care Hospital in Thailand: A Retrospective Cohort Study. PRIJNR 2022;26(2):243- 245.
  • Gupta R, Cabacungan ET. Neonatal Birth Trauma: Analysis of Yearly Trends, Risk Factors, and Outcomes. J Pediatr 2021; 238:174-180. e3.
  • Linder N, Linder I, Fridman E, et al. Birth trauma-risk factors and short-term neonatal outcome. J Matern Fetal Neonatal Med 2013;26(15):1491-1495.
  • Moczygemba CK, Paramsothy P, Meikle S, Kourtis AP, Barfield WD, Kuklina E, et al. Route of delivery and neonatal birth trauma. Am J Obstet Gynecol. 2010;202(4):361.e1-6. doi: 10.1016/j.ajog.2009.11.041.
  • Clapp MA, Bsat J, Little SE, Zera CA, Smith NA, Robinson JN. Relationship between parity and brachial plexus injuries. J Perinatol. 2016;36(5):357-61. doi: 10.1038/jp. 2015.205.
  • Abedzadeh – Kalahroudi M, Talebian A, Jahangiri M, Mesdaghinian E, Mohammadzadeh M. Incidence of Neonatal Birth Injuries and Related Factors in Kashan, Iran. Arch Trauma Res. 2015; 4 (1): e22831. doi: 10.5812/atr22831.
  • Emeka CK, Uchenna E, Tochukwu EJ, Chukwuebuka NO, Chikaodili ET, Chigozie IC. Profile of birth injuries in a tertiary hospital in Enugu, Nigeria American Journal of Biomedical and Life Sciences 2019; 7(5): 99-103.
  • Yenigül AE, Yenigül NN, Başer E, Özelçi R. A retrospective analysis of risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury: A single-center experience. Acta Orthop Traumatol Turc 2020;54(6):609-613.
  • Beall MH, Ross MG. Claviclefracture in labour: Risk factors and associated morbidities. J Prenatol 2001; 21: 513-5.
  • Lurie S, Wand S, Golan A, et al. Risk factors for fractured clavicle in the new born. J Obstet Gynaecol Res 2011; 37: 1572-4.
  • Karahanoglu E, Kasapoglu T, Ozdemirci S, et al. Risk factors for clavicle fracture concurrent with brachial plexus injury. Arch Gynecol Obstet 2016;293(4):783-787.
  • Bülbül A, Okan F, Nuhoğlu A. Yenidoğanın fiziksel doğum travmaları. Haseki Tıp Bülteni 2006; 44: 126-131.
  • Yemane A, Yeshidinber A. Birth trauma among neonates admitted to neonatal unit in a tertiary hospital in Addis Ababa. Ethiop J. Pediatr. Child Health 2019;14(1):5-11.
  • Kanat Pektaş M, Koyuncu H, Kundak AA. Long bone fractures in neonatal intensive care units of Afyonkarahisar: Five-year’s experience. Turk J Obstet Gynecol 2019;16(4):219-223.
  • Özdener T, Engin Ustun Y, Aktulay A, et al. Clavicular fracture: its prevalence mand predisposing factors in term uncomplicated pregnancy. Eur Rev Med Pharmacol Sci 2013; 17: 1269-72.
  • Onuoha KM, Omotola OE, Orimolade EA, Sotunsa JO, Alade OA and Owolabi IJ. Neonatal Birth Injuries: An Orthopedic Clinic Presentation. AJBSR 2020;7(6): 505-509.
  • Musharraf M, Jinnat MA, Morshed SS, et al. Evaluation of Risk Factors of Birth Injuries in a Tertiary Care Hospital. KYAMC Journal 2022; 13(03): 129-133.
  • Shanthi R, Senthil Kumar KS. Study of incidence, risk factors and types and outcome of birth injuries in a tertiary care hospital Int J Acad Med Pharm 2022; 4(5): 570-573.
  • Brown BL, Lapinski R, Berkowitz GS, Holzman I. Fractured clavicle in the neo nate: a retrospective three-year review. Am J Perinatol 1994; 11: 331-3.
  • Narchi H, Kulaylat NA, Ekuma-Nkama E. Clavicle fracture and brachial plexus palsy in the newborn: Risk factors and outcome. Ann Saudi Med 1996; 16: 707 10.
  • Van Vleet M, Birth Related Injury. In: Elzouki A, Harfi H, Nazer H, Stapleton FB, Oh W, Whitley R, editors. Textbook of Clinical Pediatrics. Berlin Heidelberg: Springer; 2012. pp 159-75.

Evaluation of neonatal clavicle fractures and associated risk factors.

Year 2024, Volume: 4 Issue: 2, 56 - 60, 22.08.2024
https://doi.org/10.58961/hmj.1527869

Abstract

Introduction:
Physical injuries that occur in newborns during the antenatal period are referred to as “birth trauma”. Clavicle fractures are the most common bone-related birth trauma in newborns. Our study aimed to evaluate cases in which clavicle fractures were detected during newborn examinations.
Materıals and Methods: The files of babies born in our hospital between January 1, 2022 and August 1, 2024 were retrospectively examined. In the 2.5-year period specified in our study, it was determined that the number of births in our hospital was 2756 (2022:1185,2023:1044,2024:527). Among these births, 31 newborn patients with clavicle fractures were included in the study.
Results: While 42.6% of the total births were normal spontaneous vaginal delivery, 57.4% were determined to be by cesarean section. The female/male ratio of the cases in our study was 13/18. The mean maternal age of the cases was 26.64 ± 4.61 and the mean gestational week was 39.08 ± 1.04. When the delivery method was evaluated, 29 (93.5%) cases were born by normal vaginal delivery and 2 (6.5%) cases were born by cesarean section. In our study, the case with the lowest birth weight was 2770 gr, while the case with the highest birth weight was 4640 gr. The mean birth weight of the cases was 3462.25 ± 453.11 gr. While 93.5% (n: 29) of our cases with clavicle fracture were born vaginally, 6.5% (n: 2) were born by cesarean section.
Conclusıon:In our study, clavicle fracture was detected in 1.1% of all births. In patients with suspected clavicle fracture during detailed newborn examination, diagnosis is made with direct radiography. Generally, there is a sequela-free recovery with a conservative approach. Long-term follow-up and complications can be seen in the presence of nerve damage due to the severity of birth trauma.

References

  • Silahlı N.Y., Öz N.Z. Doğum sürecinde gelişen yenidoğan üst ekstremite kırıklarının klinik özellikleri. T Kadın S Neonatol Dergisi 2023; 5(1): 1-5.
  • Phuengphaeng A, Sirisomboon R. Incidence and Risk Factors of Major Neonatal Birth Injuries in a Tertiary Care Hospital in Thailand: A Retrospective Cohort Study. PRIJNR 2022;26(2):243- 245.
  • Gupta R, Cabacungan ET. Neonatal Birth Trauma: Analysis of Yearly Trends, Risk Factors, and Outcomes. J Pediatr 2021; 238:174-180. e3.
  • Linder N, Linder I, Fridman E, et al. Birth trauma-risk factors and short-term neonatal outcome. J Matern Fetal Neonatal Med 2013;26(15):1491-1495.
  • Moczygemba CK, Paramsothy P, Meikle S, Kourtis AP, Barfield WD, Kuklina E, et al. Route of delivery and neonatal birth trauma. Am J Obstet Gynecol. 2010;202(4):361.e1-6. doi: 10.1016/j.ajog.2009.11.041.
  • Clapp MA, Bsat J, Little SE, Zera CA, Smith NA, Robinson JN. Relationship between parity and brachial plexus injuries. J Perinatol. 2016;36(5):357-61. doi: 10.1038/jp. 2015.205.
  • Abedzadeh – Kalahroudi M, Talebian A, Jahangiri M, Mesdaghinian E, Mohammadzadeh M. Incidence of Neonatal Birth Injuries and Related Factors in Kashan, Iran. Arch Trauma Res. 2015; 4 (1): e22831. doi: 10.5812/atr22831.
  • Emeka CK, Uchenna E, Tochukwu EJ, Chukwuebuka NO, Chikaodili ET, Chigozie IC. Profile of birth injuries in a tertiary hospital in Enugu, Nigeria American Journal of Biomedical and Life Sciences 2019; 7(5): 99-103.
  • Yenigül AE, Yenigül NN, Başer E, Özelçi R. A retrospective analysis of risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury: A single-center experience. Acta Orthop Traumatol Turc 2020;54(6):609-613.
  • Beall MH, Ross MG. Claviclefracture in labour: Risk factors and associated morbidities. J Prenatol 2001; 21: 513-5.
  • Lurie S, Wand S, Golan A, et al. Risk factors for fractured clavicle in the new born. J Obstet Gynaecol Res 2011; 37: 1572-4.
  • Karahanoglu E, Kasapoglu T, Ozdemirci S, et al. Risk factors for clavicle fracture concurrent with brachial plexus injury. Arch Gynecol Obstet 2016;293(4):783-787.
  • Bülbül A, Okan F, Nuhoğlu A. Yenidoğanın fiziksel doğum travmaları. Haseki Tıp Bülteni 2006; 44: 126-131.
  • Yemane A, Yeshidinber A. Birth trauma among neonates admitted to neonatal unit in a tertiary hospital in Addis Ababa. Ethiop J. Pediatr. Child Health 2019;14(1):5-11.
  • Kanat Pektaş M, Koyuncu H, Kundak AA. Long bone fractures in neonatal intensive care units of Afyonkarahisar: Five-year’s experience. Turk J Obstet Gynecol 2019;16(4):219-223.
  • Özdener T, Engin Ustun Y, Aktulay A, et al. Clavicular fracture: its prevalence mand predisposing factors in term uncomplicated pregnancy. Eur Rev Med Pharmacol Sci 2013; 17: 1269-72.
  • Onuoha KM, Omotola OE, Orimolade EA, Sotunsa JO, Alade OA and Owolabi IJ. Neonatal Birth Injuries: An Orthopedic Clinic Presentation. AJBSR 2020;7(6): 505-509.
  • Musharraf M, Jinnat MA, Morshed SS, et al. Evaluation of Risk Factors of Birth Injuries in a Tertiary Care Hospital. KYAMC Journal 2022; 13(03): 129-133.
  • Shanthi R, Senthil Kumar KS. Study of incidence, risk factors and types and outcome of birth injuries in a tertiary care hospital Int J Acad Med Pharm 2022; 4(5): 570-573.
  • Brown BL, Lapinski R, Berkowitz GS, Holzman I. Fractured clavicle in the neo nate: a retrospective three-year review. Am J Perinatol 1994; 11: 331-3.
  • Narchi H, Kulaylat NA, Ekuma-Nkama E. Clavicle fracture and brachial plexus palsy in the newborn: Risk factors and outcome. Ann Saudi Med 1996; 16: 707 10.
  • Van Vleet M, Birth Related Injury. In: Elzouki A, Harfi H, Nazer H, Stapleton FB, Oh W, Whitley R, editors. Textbook of Clinical Pediatrics. Berlin Heidelberg: Springer; 2012. pp 159-75.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Pediatric Neurology, Paediatrics (Other)
Journal Section Research Articles
Authors

Begüm Bariş Çetinkaya 0009-0002-3348-7532

Zeynep Tobcu 0000-0003-1714-6017

Alihan Tiğli This is me 0000-0002-9404-4869

Sefer Üstebay 0000-0003-1507-5921

Publication Date August 22, 2024
Submission Date August 5, 2024
Acceptance Date August 16, 2024
Published in Issue Year 2024 Volume: 4 Issue: 2

Cite

Vancouver Bariş Çetinkaya B, Tobcu Z, Tiğli A, Üstebay S. Yenidoğan klavikula kırıkları ve ilişkili risk faktörlerinin değerlendirilmesi. HMJ. 2024;4(2):56-60.

e-ISSN: 2791-9935