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Published on: February 2, 2015

Clinical-radiological features of fractures in premature infants--a review

David M Carroll1, Andrea S Doria, Babyn S Paul

  • 1Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.

Journal of Perinatal Medicine
|July 4, 2007
PubMed

Insights

Premature infants face a higher risk of bone fractures due to prematurity-related factors. Differentiating between accidental and non-accidental injury fractures in these infants requires a comprehensive diagnostic approach.

Area of Science:

  • Pediatrics
  • Orthopedics
  • Neonatology

Background:

  • Premature infants exhibit increased vulnerability to bone fractures compared to full-term infants.
  • The incidence of fractures in premature infants is variable, but the elevated risk is well-established.
  • Fractures in this population can stem from metabolic disorders, genetic conditions, accidental trauma, or non-accidental injury (NAI).

Purpose of the Study:

  • To review potential factors contributing to fractures in premature infants.
  • To explore the differential diagnoses between accidental and non-accidental injury-related fractures in this population.
  • To highlight the importance of a multi-dimensional diagnostic approach.

Main Methods:

  • Review of literature on fractures in premature infants.
  • Analysis of potential etiologies including metabolic, genetic, traumatic, and abusive causes.
  • Discussion of diagnostic challenges and strategies for differentiating fracture causes.

Main Results:

  • The increased risk of fractures in premature infants is generally confined to early childhood, typically under three years of age.
  • Distinguishing between accidental and non-accidental injury fractures is complicated by factors like birth trauma and underlying metabolic bone disease.
  • A thorough evaluation integrating imaging, bone characteristics, and psychosocial history is crucial.

Conclusions:

  • Fractures in premature infants necessitate careful etiological investigation due to overlapping risk factors with non-accidental injury.
  • A comprehensive diagnostic strategy is essential for accurate fracture diagnosis and management in vulnerable premature infants.
  • Early identification and intervention are critical, especially given the diagnostic overlap with non-accidental injury in infants under three years old.

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