Injuries to babies during birth are not uncommon. When you consider the journey a baby takes through the narrow birth canal, it becomes obvious why some babies are born with orthopedic injuries. Factors that can contribute to musculoskeletal injuries at birth include the baby’s position at the time of birth, the weight of the baby, and whether there are any underlying medical problems.
Certain fetal positions at the time of birth can contribute to a newborn acquiring an orthopedic injury. The ideal position for a baby when passing through the mother’s pelvis during birth is when the baby is head-down and facing toward the mother’s back, known as the occiput anterior position. This gives the baby more flexibility to move comfortably through the birth canal, as the smaller part of the baby’s body exits first.
If the baby is in an awkward position, it can mean a more difficult birth and a greater risk of injury. Heavier-weight newborns, and those with developmental disorders or an underlying medical condition (such as osteogenesis imperfecta, or brittle bone disease), can also be at greater risk of orthopedic injury during birth.
How Can a Baby Be Injured During Childbirth?
Several of the more common types of musculoskeletal injuries to newborn babies include the following:
Clavicle fractures are the most common type of orthopedic injury sustained at birth to newborns. The clavicle, also known as the collarbone, essentially connects the chest to the shoulder. A clavicle fracture can occur as a result of a traumatic or difficult delivery, such as if the newborn’s shoulders become stuck in the birth canal or if medical instruments are used to assist in the delivery, such as forceps.
Signs of a clavicle fracture can include the infant being in pain when moving the affected arm, excessive crying, or the inability of the baby to move their arm. A broken collarbone can be diagnosed with an X-ray or ultrasound. Usually, minor treatment such as strapping the arm to the chest is all that is required for a doctor to treat the injury.
The brachial plexus is a group of nerves located just underneath the clavicle and that branch out to the arm. There is a brachial plexus on both sides of the body, and these nerves can be injured during childbirth – either as a result of an injury to the clavicle, such as a fracture, or if the brachial plexus gets stretched when the head is pulled in one direction and the arm in the opposite direction during a difficult delivery.
The nerves may heal naturally over time. However, if they are severely damaged or fail to heal successfully, then surgery may be recommended to repair the nerves.
It is not uncommon for a baby to be born with a dislocated hip. It may be a result of a difficult or traumatic birth, but more commonly it results from a condition known as developmental dysplasia of the hip (DDH). In DDH, part or all of the ball-and-socket joint of the hip does not develop correctly, so the ball can be loose in the socket and may dislocate easily.
The condition is easily identified at birth, but it can sometimes develop during the first year of an infant’s life. Treatment often involves the baby wearing a Pavlik harness (a fabric splint) to secure the hips in a stable position, thereby allowing the hips to grow and develop normally. Surgery may be recommended in severe cases or if the harness does not correct the problem successfully.
Pediatric Orthopedics in Northeast Tennessee
At Watauga Orthopaedics, we treat a wide range of pediatric orthopedic conditions and injuries, right from the initial diagnosis to the rehabilitation stage. If you are concerned or think your child has an orthopedic condition, talk to our board-certified, fellowship-trained orthopedic surgeons for expert care.
We recognize the importance of effectively addressing the unique concerns of pediatric orthopedic injuries in order for your child to achieve a full recovery and to grow up normally. For more information or to schedule an appointment with one of our pediatric orthopedists, call Watauga Orthopaedics today at (423) 282-9011 or fill out our request form online now. We have three convenient offices in Johnson City, Kingsport, and Bristol, and we look forward to serving you and your family.