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Radiological features of healing in newborn clavicular fractures

Michael Fadell1, Angie Miller2, Laszlo Trefan3

  • 1Children's Hospital Colorado, University of Colorado, 13123 East 16th Avenue, B125, Aurora, CO, 80045, USA. michael.fadell@childrenscolorado.org.

European Radiology
|September 16, 2016
PubMed

Insights

Infant clavicle fracture healing progresses predictably, with distinct radiological signs appearing at specific times. This evidence aids in dating injuries, crucial for identifying abuse in infants.

Area of Science:

  • Pediatric Radiology
  • Skeletal Development
  • Forensic Imaging

Background:

  • Abusive fractures are common in infants.
  • Limited research exists on infant fracture healing timelines.
  • Radiological evidence is key in evaluating infant injuries.

Purpose of the Study:

  • To establish a radiological timetable for fracture healing in infants.
  • To describe the sequential appearance of healing features in neonatal clavicle fractures.
  • To provide evidence for dating infant fractures.

Main Methods:

  • Retrospective cross-sectional time-series study of birth-related clavicle fractures (2006-2013).
  • Analysis of 108 digital images from 61 infants.
  • Radiologists assessed periosteal reaction, callus, bridging, and remodeling.

Main Results:

  • Good to high inter-radiologist agreement (0.60-0.90).
  • Healing features observed: periosteal reaction (7 days), callus (11 days), bridging (20 days), remodeling (35 days).
  • Peak presence: periosteal reaction (11-42 days), callus (12-61 days), bridging (22-63 days), remodeling (49-59 days).

Conclusions:

  • Birth-associated clavicle fractures in infants show a logical healing progression.
  • Understanding these timelines aids in assessing injury timing in suspected abuse cases.
  • Provides critical evidence for fracture dating in forensic evaluations.
Abstract

Keywords:
AbuseClavicleFracture healingHealing fractureNon-accidental trauma

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