nbme 2 1 41 - dutta09

[ArchivalUser]

41. A 4080-g (9-lb) male newborn is delivered at
term to a
32-year-old woman, gravida 2, para 1. Apgar scores
are 8 and 9 at 1 and 5
minutes, respectively. Examination in the delivery
room shows fracture of
the right clavicle. Which of the following is the
most likely sequela
of this condition?

A
) Correction only with casting

B
) Correction only with physical therapy

C
) Left-hand dominance

D
) Permanent nerve damage

E
) Spontaneous healing without treatment

[ArchivalUser]

E

Because clavicular fractures in infants heal spontaneously with no long-term sequelae, parenteral reassurance and gentle handling are all that are required for management. Analgesics may be given to decrease the pain. For comfort, the arm on the affected side can placed in a long sleeved garment and pinned to the chest with the elbow at 90 degrees of flexion. Although a repeat radiograph at two weeks of age can help determine whether or not there is proper healing of the bone, lack of tenderness and callus formation detected on physical examination is usually predictive of appropriate healing.

[ArchivalUser]

thanks palakusmle

[ArchivalUser]

np