Clavicular fractures in neonates: the possible role of massage as a cause with illustrative cases

Abstract

Background: Clavicular fractures in neonates are common. Although these have been commonly associated with deliveries, they can occur in other circumstances.

Aim: To report the possible role of massage of newborns by older women in the causation of neonatal clavicular fractures.

Setting: University of Port Harcourt Teaching Hospital.

Case Report: Three neonates aged 10 days, 18 days and 8 days presented to our hospital with history of shoulder swellings and crying whenever the upper limbs on the affected side were moved. They all had massage by older women while being bathed. Physical examination confirmed the deformities which were tender with crepitus and plain chest radiographs taken at the time of presentation demonstrated the fractures without any evidence of callus formation. Repeat plain chest radiographs taken 1-2 weeks later demonstrated  united clavicular fractures. A 4th neonate presented on the 12 day of birth with history of shoulder swelling but had no history of being massaged. Physical examination confirmed the deformity which was non-tender. Plain chest radiograph taken on the 10th day of birth demonstrated a united clavicular fracture.

Conclusion: Massage of newborn by older women can result in clavicular fractures. There is need to educate these women against the practice.

Keywords:   Clavicular fracture, Neonates, Massage, Older women