Clavicle Fractures

[JVanRN]

Hey everyone,

Sorry if this is a goofy question but I'm just curious....I'm still new to NICU and havent came accross this before even though I'm sure it's kind of common...What do you do about a clavicle fracture on your units? (leave it be...splint it ect?) Does this really hurt the infant? What are the limitations of moving the infant (can you put him on his belly?). If it hurts do you give pain meds? Just curious what different doctors do for this.

I took care of a baby that had one the other night and he was soo inconsolable. I don't know if it was caused by pain r/t fx or what and I was afraid to reposition him d/t the fracture. anyway any replies would be apprediated thanks yall. :)

[KRVRN, BSN, RN]

I would assume that it hurts. I think it would probably hurt more to move and flail the injured arm around. The challenge is to get the baby to not move the injured arm. We usually swaddle the baby with one or both arms restrained. We place a little sign on the bed alerting staff to the fracture (in case someone else comes to pick up or soothe the baby), and we usually have a PRN order for tylenol. Another option I've heard of is to safety pin the sleeve of the injured arm to the t-shirt. I don't prone the baby because I personally think it would hurt, but maybe not. I mean if proning calms the baby and makes it stop wiggling around and go to sleep, then it's worth a try. We don't have any limits on holding or feeding. Could your inconsolable baby have ben upset about sometehing else? Was he NPO? Did he calm with holding? If so, maybe his main complaint was that he wanted to be held moreso than pain.

[Mimi2RN, ASN, RN]

We use Band net, or whatever you call it. The stretchy mesh tubing, that comes in different widths. I like to cut a piece about 8" or so long, as I double it. Then I put it on the babe's chest like a sleeve, with the arm on the fracture side held down at his side, and the hand and forearm across his tummy. It gives enough support that the arm doesn't move much.

Once in a while we can get a tylenol order, but I wish we could give some of them something stronger.