Risk factors for clavicle fracture concurrent with brachial plexus injury


Karahanoglu E., Kasapoglu T., Ozdemirci S., FADILOĞLU E., Akyol A., DEMİRDAĞ E., ...More

Archives of Gynecology and Obstetrics, vol.293, no.4, pp.783-787, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 293 Issue: 4
  • Publication Date: 2016
  • Doi Number: 10.1007/s00404-015-3917-5
  • Journal Name: Archives of Gynecology and Obstetrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.783-787
  • Keywords: Clavicular fracture, Brachial plexus injury
  • Hacettepe University Affiliated: Yes

Abstract

Purpose: The aim of this study was to evaluate the risk factors for clavicle fracture concurrent with brachial plexus injuries. Methods: A retrospective study was conducted at a tertiary centre. The hospital records of 62,288 vaginal deliveries were evaluated retrospectively. There were 35 cases of brachial plexus injury. Of these patients, nine had brachial plexus injuries with clavicle fracture and 26 without clavicle fracture. The analysed risk factors for clavicle fracture concurrent with brachial plexus injury were gestational diabetes, labour induction and augmentation, prolonged second stage of labour, estimated foetal weight above 4000 g, birth weight above 4000 g, risky working hours, and the requirement of manoeuvres to free the impacted shoulder from behind the symphysis pubis. Results: Labour augmentation with oxytocin increased the risk of clavicle fracture in cases of brachial plexus injury (OR 6.67; 95% CI 1.26–35.03). A birth weight higher than 4000 g also increased the risk of clavicle fracture. Risky working hours, gestational diabetes, estimated foetal weight higher than 4000 g, and requirement of shoulder dystocia manoeuvres did not increase the risk of clavicle fracture. Conclusions: Labour augmentation and actual birth weight higher than 4000 g were identified as risk factors for clavicle fracture in cases of brachial plexus injury.