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Multiple Rib Fractures Due to Physiotherapy in a Neonate With Hyaline Membrane Disease

Am J Dis Child. 1975;129(9):1103-1104. doi:10.1001/archpedi.1975.02120460083020.
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Physical therapy to the chest has been recommended as an adjunct to the treatment of hyaline membrane disease.1 Especially for babies receiving mechanical respiratory assistance, postural drainage and percussion are thought to be of value in the prevention of pulmonary atelectasis due to secretions. Also in bronchopulmonary dysplasia, the presence of mucous secretion, metaplastic changes in bronchiolar epithelium, and fibrosis2 has prompted the use of pulmonary chest therapy in many nurseries. However, the beneficial effect of such therapy has not been proved. Recently, endotracheal suctioning at birth, combined with physical therapy in the first eight hours of life, has been shown to be of value in neonates with meconium aspiration.3 No specific complication from chest therapy has been reported to our knowledge until the present case.

Report of a Case.—A boy weighing 2.1 kg (4.6 lb) with a gestational age of 32 weeks was admitted to


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