Which types of fractures are characteristic of physical child abuse?

Updated: Apr 24, 2017
  • Author: Angelo P Giardino, MD, MPH, PhD; Chief Editor: Caroly Pataki, MD  more...
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Skeletal injuries in children younger than 2 years may not be obvious; therefore, a skeletal survey screening is recommended. Many fracture types can be accidental or inflicted. Fractures that raise a high degree of suspicion for inflicted injury include the following:

  • Any fracture in a nonambulatory infant without clear accidental and consistent mechanism

  • Metaphyseal fractures

  • Multiple, bilateral, differently aged posterior rib fractures

  • Multiple and complex skull fractures if only simple impact history

  • Spinous process fractures

  • Scapular fractures

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