Table 3.

Fracture Characteristics of Infants Diagnosed With Child Abuse

GroupNumber of
Cases
Mean Number and
Location of Rib Fractures
Rational for Diagnoses of Abuse
193.5/patient (range: 1–6)Subdural hematomas, retinal hemorrhages, multiple fractures indicative of abuse (ie, metaphyseal fractures) in various stages of healing, liver lacerations, and bruising in various combinations
 Posterior arc: 13
 Midposterior: 8
 Lateral: 11
 Anterior: 0
252.2/patient (range: 1–4)Confessions of abuse by perpetrator
 Posterior arc: 3
 Midposterior: 0
 Lateral: 4
 Anterior: 4
3125.2/patient (range: 1–12)Multiple fractures, some with various stages of healing. All lacked a history of trauma
 Posterior arc: 222 with negative biopsies for OI
 Midposterior: 16
 Lateral: 21
 Anterior: 3
462.3/patient (range: 1–6)No history of trauma. Follow-up with primary care physicians revealed no additional injuries, short stature, or easy bruisability to help exclude OI. Birth injury excluded and/or normal previous radiographs
 Posterior arc: 4
 Midposterior: 6
 Lateral: 4
 Anterior: 0