Palpable spongy mass over the clavicle, an underutilized sign of clavicular fracture in the newborn

Charles H. Reiners, Abdul Kader Souid, Michael Oliphant, Nancy Newman

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


This prospective study emphasizes the importance of an early physical finding of neonatal clavicular fracture, termed "the palpable spongy mass sign." Of the 1,661 term neonates examined at our tertiary center over a 20-month period, 24 had clinical signs of a clavicular fracture. In 22 of the 24 neonates, the fractures were documented by positive radiographs or callus formation. None of the fractures was recognized because of an asymmetric Moro reflex, visible swelling, or bruising. The palpable spongy mass was present in 18 of the 22 fractures (82%), crepitus in 10 (45%), angulation deformity in two (9%), and localized tenderness in one (5%). Any combination of crepitus, deformity, and localized tenderness was detected in 11 of the 22 (50%) fractures. When the palpable spongy mass sign was added to these three signs, all but one fracture was clinically detected (95%), emphasizing the importance of using all physical findings. We conclude that "the clavicular spongy mass sign" is highly sensitive and predictive of neonatal clavicular fractures.

Original languageEnglish
Pages (from-to)695-698
Number of pages4
JournalClinical Pediatrics
Issue number12
Publication statusPublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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