Clavicle Fractures During Birth: Causes, Treatment, and When It’s Medical Negligence
Understanding collarbone injuries, the healing process, and your legal rights if your newborn suffered a preventable fracture
A clavicle fracture—commonly called a broken collarbone or broken collar bone—is the most common bone injury sustained by newborns during delivery. While many clavicle fractures during birth heal naturally without complications, understanding the causes, treatment options, and when medical negligence may be involved is critical for families seeking answers and accountability.
This comprehensive guide covers everything parents need to know about clavicle fractures during birth, including what causes them, how they’re treated, when they indicate medical negligence, and your legal rights under New York law.
What Is a Clavicle Fracture?
The clavicle (collarbone) is a long, slender bone that connects the sternum (breastbone) to the shoulder. During birth, this bone can fracture when pressure is applied to the area during delivery, particularly in difficult or traumatic labor and delivery situations.
Clavicle fractures are the most frequently occurring birth injuries, though they’re not always detected immediately. Some parents may only notice the fracture weeks after birth when a hard lump (callus formation) appears at the healing site. Medical professionals confirm suspected fractures through X-rays or ultrasound imaging.
How Common Are Clavicle Fractures During Birth?
Research shows that clavicle fractures occur in approximately 1 to 3 out of every 100 newborns, making them far more common than many parents realize. Despite this frequency, most clavicle fractures in newborns heal completely without intervention.
The key distinction lies between unavoidable fractures that occur even with appropriate medical care and preventable fractures resulting from medical negligence or improper delivery techniques.
Causes of Clavicle Fractures During Birth
Clavicle fractures during delivery result from physical pressure and trauma to the shoulder area. Understanding the specific causes helps determine whether a fracture was preventable or unavoidable.
Primary Causes
- Shoulder dystocia (baby’s shoulder becomes stuck behind the mother’s pubic bone)
- Forceps-assisted delivery
- Vacuum extraction delivery
- Difficult or prolonged labor
- Large baby size (macrosomia) relative to mother’s pelvic size
Risk Factors Increasing Fracture Risk
- Maternal diabetes (pre-existing or gestational)
- Maternal obesity or excessive pregnancy weight gain
- Maternal age over 35
- Abnormal pelvic structure or maternal short stature
- Post-term pregnancy (delivery after due date)
- Newborn birth weight over 8 pounds 13 ounces
The Role of Shoulder Dystocia in Clavicle Fractures
Shoulder dystocia is the most significant risk factor for clavicle fractures during birth. This obstetric emergency occurs when the baby’s anterior (front) shoulder becomes impacted behind the mother’s pubic symphysis, preventing the baby from moving down the birth canal normally.
When shoulder dystocia occurs, medical providers must act quickly using specific maneuvers to free the trapped shoulder. These include the McRoberts maneuver (positioning the mother on her back with thighs pressed against her abdomen), suprapubic pressure, internal rotation techniques, and the Gaskin maneuver (repositioning to hands and knees).
In severe cases where these standard techniques fail to resolve the dystocia, physicians may intentionally fracture the baby’s clavicle as a last-resort emergency measure to allow the shoulders to pass through the birth canal. This intentional fracture is different from trauma-related fractures and is considered an emergency response to save the baby’s life when other methods have failed.
Important: Research shows that obstetricians can often anticipate shoulder dystocia risk using pregnancy factors such as maternal diabetes, obesity, and fetal weight estimates. Proper prenatal monitoring and appropriate delivery planning can reduce the frequency of emergency shoulder dystocia situations.
Signs and Symptoms of Clavicle Fracture in Newborns
Parents and medical staff should watch for specific signs that indicate a possible clavicle fracture:
| Sign/Symptom | Description | When It Appears |
|---|---|---|
| Fussiness and crying when moving the affected arm | Baby appears uncomfortable when the affected arm moves | Immediately after birth or within first hours |
| Pain when lifted under the arms | Baby cries or shows distress during diaper changes or lifting | First few days after birth |
| Reduced arm movement on affected side | Baby holds the injured arm immobile against their body | Immediately apparent to attentive parents |
| Shoulder asymmetry | The injured shoulder appears visibly lower than the other side | Noticeable in first few days |
| Hard lump at the fracture site | Callus formation becomes palpable on the collarbone | Several weeks after birth (healing process) |
How Are Clavicle Fractures Diagnosed?
Medical professionals use imaging to confirm suspected clavicle fractures when clinical signs suggest injury. Diagnostic methods include:
- Chest X-rays: The primary diagnostic tool to visualize the fracture and assess severity
- Ultrasound imaging: Often used as an alternative, particularly in specialized obstetric and neonatal settings
- Physical examination: Experienced clinicians may palpate (feel) the fracture site, though subtle fractures may not be immediately apparent
Interestingly, many newborns heal so effectively that fractures may become undetectable on X-ray imaging within weeks. Some parents only learn their newborn had a clavicle fracture when they see the hard lump that develops at the healing site weeks later.
Treatment of Clavicle Fractures in Newborns
The good news for families is that clavicle fractures in newborns require minimal medical intervention and heal exceptionally well. Most newborns recover completely without surgery or intensive treatment.
Standard Treatment Approach
Treatment typically involves conservative, non-surgical management:
Immobilization Methods
- Gentle handling of the newborn to minimize movement and discomfort
- Pinning the affected arm’s sleeve to the front of the baby’s clothing
- Using soft restraint to limit arm movement for 7-10 days
- Careful handling during diaper changes and bathing
Parental Support
- Reassurance from medical staff about excellent healing outcomes
- Clear instructions on gentle handling techniques
- Pain management if the infant shows discomfort
- Follow-up monitoring to ensure proper healing
Why Surgery Is Rarely Needed
Newborns have exceptional bone-healing capacity. Unlike older children or adults, infants’ clavicles contain significant cartilage and are highly vascular (well-supplied with blood vessels), promoting rapid healing. Surgical intervention is virtually never required for newborn clavicle fractures because:
- The bone heals naturally within 7-10 days
- Alignment usually occurs without manual reduction
- The risk of surgery complications exceeds potential benefits
- Non-surgical management has 99%+ success rates
The Healing Timeline and Prognosis
Most newborn clavicle fractures follow a predictable, positive healing course:
Excellent Prognosis: The natural history of isolated birth fractures to the extremities, including the clavicle, is uneventful rapid healing without lasting complications.
Healing Timeline
- Days 1-7: Initial healing phase; parents manage pain and immobilization
- Days 7-14: Bone fusion occurs; infant can gradually increase arm movement
- Weeks 2-4: Visible callus (hard lump) begins to form at the fracture site
- Weeks 4-12: Callus remodels and gradually reshapes to normal bone architecture
- Months 2-12: Complete resorption of callus; bone returns to normal appearance and function
Long-Term Prognosis
In the vast majority of cases (over 99%), clavicle fractures in newborns result in:
- Complete bone healing without deformity
- Full restoration of arm and shoulder function
- No limitations on movement or physical activity
- No cosmetic concerns as the bone fully remodels
- No long-term pain or discomfort
This excellent prognosis distinguishes simple clavicle fractures from more serious birth injuries that may cause permanent damage.
Complications of Clavicle Fractures During Birth
While isolated clavicle fractures typically heal without problems, complications can occur—particularly when the fracture is associated with other birth injuries:
Brachial Plexus Injuries
The most significant complication involves the brachial plexus, a network of nerves that control arm and shoulder movement. Research shows that approximately 1 out of every 11 newborns with a clavicle fracture also sustains damage to their brachial plexus.
Brachial plexus injuries can cause:
- Temporary paralysis or weakness in the affected arm
- Inability to move the shoulder or raise the arm
- Numbness or tingling in the arm and hand
- Erb’s palsy (upper arm weakness) or other brachial plexus patterns
- In severe cases, permanent arm weakness or limited mobility
It’s important to note that when brachial plexus injury accompanies clavicle fracture, the nerve damage—not the broken bone—represents the serious long-term concern.
Other Rare Complications
Note: Other rare complications associated with severe birth trauma involving clavicle fractures may include injuries to the phrenic nerve (affecting breathing) or recurrent laryngeal nerve (affecting voice), but these are uncommon and usually appear only when multiple serious injuries occur simultaneously.
When Is a Clavicle Fracture Preventable?
This critical question separates unavoidable birth injuries from cases of potential medical negligence. While clavicle fractures can occur even with appropriate medical care, research and medical standards identify specific circumstances where fractures may have been preventable:
Preventable Risk Factors and Standards of Care
Medical standards require obstetricians to:
| Standard of Care Requirement | Why It Matters | Failure to Comply = Negligence Risk |
|---|---|---|
| Screen for shoulder dystocia risk factors during pregnancy | Diabetes, obesity, and fetal weight estimates predict problems | Missed risk factors prevent preventive strategies |
| Obtain accurate fetal weight estimates via ultrasound | Large babies significantly increase dystocia risk | Overestimation may lead to unnecessary C-sections; underestimation to inadequate preparation |
| Plan delivery appropriately based on risk assessment | High-risk patients may need planned C-section delivery | Forcing vaginal delivery in high-risk cases increases injury risk |
| Use proper delivery techniques and avoid excessive traction | Excessive pulling on baby’s head and arm causes fractures | Improper delivery technique directly causes preventable fractures |
| Respond appropriately to shoulder dystocia | Standard maneuvers (McRoberts, suprapubic pressure) resolve most cases | Failure to use proper technique or call for help increases injury risk |
| Document the delivery and any complications | Medical records establish what happened and why | Missing or altered records raise negligence suspicions |
Red Flags Suggesting Possible Negligence
The following circumstances warrant evaluation by a birth injury attorney to determine if medical negligence occurred:
Failure to Anticipate
- Missed diagnosis of gestational diabetes
- No ultrasound to estimate fetal weight
- Failure to assess pelvic adequacy
- No discussion of delivery risk with parents
- Pushing past due date without delivery planning
Improper Delivery Technique
- Excessive traction or pulling during delivery
- Violent or forceful maneuvers
- Using excessive force with delivery tools (forceps/vacuum)
- Improper handling of shoulder dystocia
- Failure to call for specialized assistance (pediatrics, anesthesia)
Legal Standards for Medical Negligence in Birth Injuries
Under New York law, to establish that medical negligence caused your baby’s clavicle fracture, you must prove four essential elements:
Four Elements of Medical Malpractice
- Duty of Care: The healthcare provider (obstetrician, midwife, hospital) owed your baby a legal duty to provide competent obstetric care during delivery.
- Breach of Duty: The provider failed to meet the standard of care expected of a competent obstetrician. This might include failing to diagnose risk factors, choosing inappropriate delivery methods, or using improper techniques.
- Causation: The provider’s breach directly caused your baby’s clavicle fracture. This requires expert medical testimony that appropriate care would have prevented the injury.
- Damages: Your baby suffered measurable harm—medical expenses, pain and suffering, permanent disability, or other losses—as a result of the fracture.
Medical negligence claims require expert testimony from an experienced obstetrician or maternal-fetal medicine specialist to establish that the defendant’s care fell below acceptable standards.
Distinguishing Preventable from Unavoidable Fractures
Not every clavicle fracture indicates negligence. Medical experts understand that some fractures occur despite appropriate, competent care:
Unavoidable Fractures
- Fractures in mothers with no identified risk factors who experience unexpected shoulder dystocia despite proper technique
- Fractures in babies with unexpected macrosomia (large size) not detected on prenatal ultrasound
- Fractures where the obstetrician properly applied standard shoulder dystocia maneuvers and the baby was delivered safely
- Intentional fractures performed as an emergency measure after other techniques failed (to save the baby’s life)
Potentially Preventable Fractures
- Fractures resulting from missed or poorly managed shoulder dystocia in high-risk pregnancies
- Fractures caused by excessive traction or improper delivery technique
- Fractures in babies of diabetic or obese mothers where risk was not managed
- Fractures where delivery should have been planned as cesarean section based on risk factors
- Fractures where emergency procedures (like calling for pediatric assistance) were not initiated
What About Settlement or Compensation?
In medical malpractice cases involving preventable clavicle fractures, families may recover compensation for:
Economic Damages
- Medical treatment costs and hospital bills
- Ongoing medical care and follow-up
- Therapy or rehabilitation expenses
- Lost wages for parents (lost work time)
- Future medical care if complications develop
Non-Economic Damages
- Pain and suffering of the injured baby
- Emotional distress of parents
- Loss of enjoyment of normal childhood activities
- Permanent disfigurement or functional limitations
- Diminished quality of life
It’s important to note that most straightforward clavicle fractures—even if technically caused by negligence—result in minimal long-term harm given their excellent healing outcomes. More significant compensation typically applies when clavicle fractures are accompanied by serious complications like permanent brachial plexus injury.
How to Determine If Your Case Has Merit
If your baby suffered a clavicle fracture during birth and you’re concerned about medical negligence, these steps can help evaluate whether a legal case might have merit:
Gather Medical Records: Obtain complete medical records from your prenatal care, delivery, and hospital stay. These documents reveal what information the medical team had and what decisions they made.
- Document Your Baby’s Condition: Keep detailed records of any symptoms, treatment, pain, or limitations your baby experienced. Photograph any visible injuries or asymmetry.
- Research the Medical Standards: Understand what standard obstetric care requires in cases like yours. This often requires expert medical guidance.
- Consult a Birth Injury Attorney: An experienced New York birth injury attorney can review your specific situation, consult with medical experts, and determine whether negligence occurred and whether a claim has potential value.
- Understand Statute of Limitations: In New York, you generally have 2.5 years from birth (or when the injury was discovered) to file a lawsuit, plus an additional period until age 8 for minors. Don’t delay in consulting an attorney.
When to Contact an Attorney
You should consider consulting a birth injury attorney if:
- Your baby’s clavicle fracture was accompanied by other serious injuries (especially brachial plexus injury)
- You have concerns that improper delivery technique caused the fracture
- Medical records suggest missed risk factors or inappropriate delivery decisions
- Your baby experienced unusual complications or unusually prolonged healing
- You believe the medical team failed to provide adequate explanation of what happened
- Your baby’s injury resulted in permanent disability or ongoing medical needs
Have Questions About Your Baby’s Clavicle Fracture?
If your newborn suffered a clavicle fracture during delivery and you’re concerned about medical negligence, qualified birth injury attorneys can help. Get a free case evaluation with no obligation to understand your legal rights.
Frequently Asked Questions About Clavicle Fractures
Can a clavicle fracture cause permanent damage to my baby?
Most clavicle fractures in newborns heal completely without permanent damage. The bone heals exceptionally well, and long-term complications are rare. However, if the fracture is accompanied by brachial plexus nerve injury, that nerve damage—not the broken bone—may cause lasting limitations. Isolated clavicle fractures typically result in full recovery with no lasting effects.
How long does it take for a newborn’s clavicle to heal?
The clavicle bone typically fuses within 7-10 days in newborns. During this time, babies benefit from gentle handling and arm immobilization. A hard lump (callus) develops at the fracture site within weeks and gradually remodels over 2-12 months until the bone returns to normal appearance and function.
Do babies need surgery for a broken collarbone?
No. Surgery is virtually never required for newborn clavicle fractures. Babies’ bones heal naturally and exceptionally well. Non-surgical management with gentle handling and immobilization achieves excellent outcomes in 99%+ of cases. The risks and complications of surgery far exceed any potential benefits in newborns.
What’s the difference between an unavoidable and preventable clavicle fracture?
An unavoidable fracture occurs despite appropriate medical care—for example, unexpected shoulder dystocia that the medical team properly managed using standard techniques. A preventable fracture results from medical negligence—such as failure to anticipate risk factors, improper delivery technique, or failure to respond appropriately to complications. Determining which type occurred requires expert medical review.
Should I worry if my baby has a clavicle fracture?
While a clavicle fracture is certainly concerning, the overwhelming evidence shows excellent outcomes. Most babies recover completely without intervention. However, you should ensure that: 1) your baby is examined thoroughly for other injuries, especially nerve damage, 2) medical staff provide clear information about expected healing, and 3) you receive guidance on proper handling. If complications develop or you have concerns about how the fracture occurred, consult a healthcare provider or attorney.
Can I sue for a clavicle fracture even if it healed well?
Theoretically yes, but practically the value of such a case is limited. Medical malpractice requires proving that the healthcare provider breached the standard of care, and damages flow from the actual harm your child suffered. If the fracture healed without complications, permanent injury, or lasting effects, damages are limited to any treatment costs and pain and suffering during the healing period. Cases become more viable when fractures are accompanied by serious complications like permanent nerve injury.
What’s the connection between shoulder dystocia and clavicle fractures?
Shoulder dystocia—when the baby’s shoulder becomes stuck during delivery—is the most common cause of clavicle fractures. When standard shoulder dystocia maneuvers (McRoberts position, suprapubic pressure, etc.) fail to free the trapped shoulder, some doctors may intentionally fracture the clavicle as an emergency measure to allow the shoulders to pass. In other cases, the trauma of shoulder dystocia itself causes the fracture. Proper anticipation and management of shoulder dystocia risk can often prevent these fractures.
How do I know if my baby’s fracture was the result of medical negligence?
Determining negligence requires expert medical review. You need to understand: 1) What risk factors the medical team should have anticipated before labor, 2) What decisions they made about delivery planning, 3) How they managed labor and delivery, 4) How they responded when complications occurred, and 5) Whether their care met the standard expected of a competent obstetrician. A birth injury attorney can guide this evaluation and connect you with qualified medical experts.
What should I do if I think my baby’s clavicle fracture was caused by medical negligence?
First, obtain complete medical records from pregnancy, delivery, and hospital stay. Document your baby’s condition, symptoms, and any treatment. Then consult with a birth injury attorney experienced in New York medical malpractice law. Attorneys offer free case evaluations to assess whether negligence occurred and whether your case has legal merit. Don’t delay—New York has strict time limits for filing claims (2.5 years from birth for adults, until age 8 for minors).
Key Takeaways
Understanding clavicle fractures during birth empowers families to make informed decisions about their baby’s care and their legal rights:
- Clavicle fractures are the most common birth injury, occurring in 1-3 out of 100 newborns
- Most fractures heal naturally within 7-10 days without surgery or lasting complications
- Shoulder dystocia is the most common cause, though many fractures occur without obvious complications
- While many fractures are unavoidable, some result from medical negligence in anticipating risks or managing delivery
- Significant complications (particularly brachial plexus injury) deserve immediate medical and legal evaluation
- Determining whether negligence occurred requires expert medical review and detailed analysis of medical records
- New York law allows families to recover compensation if negligence can be proven
- Time limits apply—don’t delay in consulting an attorney if you have concerns about negligence
If your family experienced a clavicle fracture during birth and you have questions about whether medical negligence was involved, a qualified New York birth injury attorney can provide answers and guidance tailored to your specific situation.
