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Fractures and Skeletal Injuries

  • Angela BachimEmail author
  • Nancy S. Harper
Chapter

Abstract

The identification of a skeletal injury may be the first indication of abuse. Estimates of the frequency of fractures in abused children vary from approximately 10–50%, depending on the population studied, the type of diagnostic imaging used to detect fractures, and the age of the patients seen (Ebbin et al., Am J Dis Child 118(4):660–667, 1969; Herndon, J Pediatr Orthop 3(1):73–76, 1983; Leventhal et al., Am J Dis Child 147(1):87–92, 1993). Recently, large population-based studies have been used to estimate the incidence of inflicted skeletal trauma. While the majority of fractures are still attributed to falls, child abuse accounts for 12% of fractures in children less than 36 months of age (Leventhal et al., Pediatrics 122(3):599–604, 2008). Infants and young children sustain significantly more abusive skeletal injuries than do older children, with the majority of inflicted fractures occurring in children under 12 months of age (Leventhal et al., Pediatrics 122(3):599–604, 2008; Leventhal et al., Pediatrics 126(1):e104–e115, 2010; Loder and Feinberg, J Pediatr Orthop 27(4):421–426, 2007; Sibert et al., Child Abuse Negl 26(3):267–276, 2002). Fractures of the ribs, arm, and leg account for over half of the inflicted skeletal injuries in young children (Leventhal et al., Pediatrics 122(3):599–604, 2008; Starling et al., Child Abuse Negl 31(9):993–999, 2007). These injuries are often occult and detected only with detailed skeletal imaging.

Keywords

Fractures Skeletal injuries Bone anatomy Skull fracture 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Baylor College of MedicineHoustonUSA
  2. 2.Texas Children’s HospitalHoustonUSA
  3. 3.University of MinnesotaMinneapolisUSA
  4. 4.Child Abuse PediatricsUniversity of Minnesota Masonic Children’s HospitalMinneapolisUSA

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