Vigorous Oil Massage in a Neonate: Cause for Fracture

Abstract

Massaging the newborn has been a tradition in India and other Asian countries since time immemorial. There are many benefits of traditional oil massage. Although considered as a safe practice with no significant harmful effects, rarely if performed improperly baby may end up having adverse effects like fracture. We report a forearm fracture in a neonate following vigorous oil massage. A 15 days old male baby was brought with the complaints of reduced movement, pain and swelling in right forearm of one day duration. The baby was born full term to a non consanguineous parent. His birth weight was 3.12kg and APGAR score was good. Post natal period was uneventful except for neonatal hyperbilirubinemia for which he had received phototherapy. At home he was getting daily oil massage and bath by traditional techniques. On examination there was diffuse, tender swelling on the ventral aspect of right forearm which was firm in consistency and there was paucity of movement. X ray revealed fracture of proximal radius and middle third of ulna. Skeletal survey did not reveal any other fracture. Baby was treated with a short arm, below the elbow cast. Absence of family history and no other bone involvement made osteogenesis imperfecta and child abuse less likely. In conclusion simple causes like oil massage also to be kept in mind in dealing with neonatal fractures.