Introducción: La fractura clavicular neonatal es una complicación frecuente, está asociado a múltiples factores y es indicador de calidad de atención del parto institucional. Objetivo: Determinar la incidencia y características clínicas de la fractura clavicular neonatal. Diseño: Cuantitativo, epidemiológico, de estudio estadístico, descriptivo. Lugar: Hospital Nacional Sergio E. Bernales. Participantes: Población: neonatos que presentaron fractura clavicular. Intervenciones: Se elaboró y usó una ficha de recolección de datos. Resultados: En el Hospital Nacional Sergio E. Bernales, durante el período 2009 - 2013, se atendieron 29110 partos, registrándose 252 casos de fractura clavicular neonatal, obteniéndose una incidencia de 0,9%. Conclusiones: Incidencia de fractura clavicular neonatal en el Hospital Nacional Sergio E. Bernales, durante el periodo 2009 - 2013: 0,9%. Factores asociados: edad materna entre 20 a 34 años, multiparidad, edad gestacional entre 37 a 42 semanas. La fractura se produjo: partos eutócicos en neonatos a término, sexo femenino, peso mayor a 3500 gramos y perímetro cefálico entre 32 a 36 cm. El diagnóstico clínico fue: por médico especialista entre los días 2° y 3° de vida, localización frecuente fue: clavícula derecha, tercio medio y el tipo de fractura fue: no desplazada. Palabras clave: Fractura clavicular neonatal, tipo de parto, distocias, macrosómico. / --- Introduction: Neonatal clavicle fracture is a common complication, is associated with multiple factors and is an indicator of quality of care in hospital parturition. Objective: To determine the incidence and clinical features of neonatal clavicular fracture. Design: Quantitative, epidemiological, statistical, descriptive study. Location: Sergio E. Bernales National Hospital. Participants: Population: neonates who had clavicular fracture. Interventions: It was developed and used a data collection sheet. Results: Sergio E. Bernales National Hospital during the period 2009 - 2013, 29110 births were attended, recorded 252 cases of neonatal clavicular fracture, yielding an incidence of 0.9%. Conclusions: Incidence of neonatal clavicular fracture Sergio E. Bernales National Hospital during the period 2009 - 2013: 0.9%. Factors associated with maternal age between 20-34 years multiparity, gestational age between 37-42 weeks. The fracture occurred: normal parturitions in term neonates, female, weight greater than 3500 grams and head circumference between 32-36 cm. The clinical diagnosis was by specialist between the 2nd and 3rd of life, frequent location was, right clavicle, middle third and the fracture was, not displaced. Keywords: neonatal clavicular fracture, type of parturition, dystocia, macrosomic.

<p>During a three-year period (1989-91), all patients living in the county of Uppsala, Sweden, with a radiographically verified fracture of the clavicle were prospectively, consecutively followed (n=245). </p><p>The epidemiological study (I) was restricted to the two first years with 187 fractures in185 patients. The short term study (II) with 6 months follow-up included 222 patients. The long term study (III) with 10 years follow-up included 208 patients. The malunion study (IV) included eight patients and the nonunion study (V) 24 patients all of whom were consecutively operated between 1988-2000.</p><p>Displacement, especially with no bony contact in the initial radiographs, was a statistically significant risk factor for sequelae.</p><p>Comminute fractures, especially if including transversally placed fragments, were associated with a significantly increased risk of remaining symptoms. An increasing number of fragments was also associated with an increased risk of sequelae.</p><p>Patients with remainig symptoms after 6 months were on average older at the time of injury as compared to patients without remaining symptoms. Advancing age was also a significant risk factor for sequelae – specifically pain at rest – still after 10 years.</p><p>There was no difference between gender with respect to the risk of sequelae, except for nonunion.</p><p>Fracture location did not predict outcome, except for more cosmetic defects (middle part).</p><p>Shortening defined as overlapping at the fracture site was a significant risk factor for cosmetic defects after 10 years.</p><p>Patients who experience pain at rest and/or cosmetic defects more than twelve weeks after the fracture have a higher risk for sequelae.</p><p>The radiographic examination should always consist of two projections: the AP (0°) view and the 45° tilted view. Transversally placed fragments are not seen in the 0° view.</p><p>Removal of excessive callus in patients with persistent symptoms even several years after the fracture showed a good outcome. One does not have to stabilize the clavicle when excising the hypertrophic callus.</p><p>Symptomatic clavicular nonunions should be treated with surgery. Reconstruction plate combined with cancellous bone gives a faster and more reliable healing rate than external fixation.</p>

During a three-year period (1989-91), all patients living in the county of Uppsala, Sweden, with a radiographically verified fracture of the clavicle were prospectively, consecutively followed (n=245). The epidemiological study (I) was restricted to the two first years with 187 fractures in185 patients. The short term study (II) with 6 months follow-up included 222 patients. The long term study (III) with 10 years follow-up included 208 patients. The malunion study (IV) included eight patients and the nonunion study (V) 24 patients all of whom were consecutively operated between 1988-2000. Displacement, especially with no bony contact in the initial radiographs, was a statistically significant risk factor for sequelae. Comminute fractures, especially if including transversally placed fragments, were associated with a significantly increased risk of remaining symptoms. An increasing number of fragments was also associated with an increased risk of sequelae. Patients with remainig symptoms after 6 months were on average older at the time of injury as compared to patients without remaining symptoms. Advancing age was also a significant risk factor for sequelae – specifically pain at rest – still after 10 years. There was no difference between gender with respect to the risk of sequelae, except for nonunion. Fracture location did not predict outcome, except for more cosmetic defects (middle part). Shortening defined as overlapping at the fracture site was a significant risk factor for cosmetic defects after 10 years. Patients who experience pain at rest and/or cosmetic defects more than twelve weeks after the fracture have a higher risk for sequelae. The radiographic examination should always consist of two projections: the AP (0°) view and the 45° tilted view. Transversally placed fragments are not seen in the 0° view. Removal of excessive callus in patients with persistent symptoms even several years after the fracture showed a good outcome. One does not have to stabilize the clavicle when excising the hypertrophic callus. Symptomatic clavicular nonunions should be treated with surgery. Reconstruction plate combined with cancellous bone gives a faster and more reliable healing rate than external fixation.