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Novel classification system of rib fractures observed in infants

Jennifer C Love1, Sharon M Derrick, Jason M Wiersema

  • 1Forensic Anthropology Division, Harris County Institute of Forensic Sciences, 1885 Old Spanish Trail, Houston, TX, 77054.

Journal of Forensic Sciences
|February 15, 2013
PubMed

Insights

A new classification system for infant rib fractures was developed and tested. This robust system accurately categorizes rib fracture types and locations, aiding research into nonaccidental injuries.

Area of Science:

  • Pediatric medicine
  • Forensic pathology
  • Radiology

Background:

  • Rib fractures in infants are highly indicative of nonaccidental injury.
  • A standardized classification system for infant rib fractures is currently lacking.
  • Existing literature lacks a structured approach to categorizing these injuries.

Purpose of the Study:

  • To develop a concise schema for classifying infant rib fracture types and locations.
  • To provide a tool to aid and stimulate research on infant rib fractures.
  • To establish a standardized method for documenting and analyzing rib fractures in infants.

Main Methods:

  • A classification system was developed, defining four fracture types (sternal end, buckle, transverse, and oblique) and four rib regions (posterior, posterolateral, anterolateral, and anterior).
  • The schema was applied to all rib fractures identified during 85 consecutive infant autopsies.
  • The adequacy of the classification system was assessed based on the proportion of fractures it could categorize.

Main Results:

  • Rib fractures were identified in 24% (24 of 85) of the infant autopsies.
  • A total of 158 rib fractures were observed and classified.
  • The proposed classification schema successfully categorized 97% (153 of 158) of the observed rib fractures.

Conclusions:

  • The developed classification system is robust and adequate for categorizing infant rib fractures.
  • This system should be adopted by researchers investigating infant rib fractures.
  • Standardized classification will improve consistency and comparability in research on nonaccidental infant injuries.

Keywords:
child abuseforensic anthropologyforensic pathologyforensic scienceinfantsrib fractures

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