If deficient, platelets or clotting factors should be given. Subdural hematomas should be treated with daily bilateral subdural taps if the infant is symptomatic or the head is enlarging rapidly. Only 10 to 15 mL of subdural fluid should be removed from each side at one time, because removing larger amounts may precipitate shock. If symptoms persist after 2 wk of daily drainage, insertion of a subdural shunt should be considered. The infant is first noted to be irritable and does not move the arm on the involved side either spontaneously or when the Moro reflex is elicited.
Most clavicular fractures are greenstick and heal rapidly and uneventfully.
A large callus forms at the fracture site within a week, and remodeling is completed within a month. The humerus and the femur may be fractured during difficult deliveries. Most of these fractures are greenstick, mid-shaft fractures, and excellent remodeling of the bone usually follows, even if moderate angulation occurs initially. A long bone may be fractured through its epiphysis, but even here the prognosis for newborns is excellent. All soft tissues are susceptible to injury if they have been the presenting part or the fulcrum for the forces of uterine contraction.