Ultrasound Diagnosis of Clavicle Fractures in Newborns: A Systematic Review.

BACKGROUND

Fractures of the clavicle are the most common birth injury among newborns. Aim of this systematic review was to provide a comprehensive analysis of the role of ultrasound (US) in diagnosing clavicular fractures in neonates.

METHODS

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed and Embase, including studies focusing on US in neonatal clavicle fracture. Age at US, number of cases examined by US and X-ray, US and X-ray diagnoses, US probe used, fracture site were systematically extracted.

RESULTS

A total of 231 articles were found. We ultimately selected 7 publications that satisfied the inclusion criteria, involving 136 patients examined between 3 days and 3 weeks of age, with 135 confirmed fractures. US was performed on all patients and correctly diagnosed all fractures (135/135, 100%). X-ray was performed on 94/136 patients (69.1%) and correctly diagnosed 89/93 fractures (95.7%). Fracture site was: medial in 2/79, middle in 37/79, and lateral in 40/79. In the remaining 57 cases, site was not reported.

CONCLUSIONS

This review indicates that ultrasound is extremely reliable in diagnosing clavicle fractures in newborns and should be considered as the gold standard in this context.