Analysis of 429 fractures in 189 battered children

To assess empirically the radiologic appearance of fractures among victims of child abuse, the charts and radiographs of 189 battered children exhibiting fractures (n = 429 total fractures) were studied. Approximately one-half of the patients had a single fracture. Bones most commonly fractured were the humerus, femur, and tibia; transverse fractures were the most common type. Of long bone fractures, the middle third (50%) and distal third (41%) locations were most prominent. Age, race, and gender were not associated with any particular long bone fracture type. Skull fractures were the only type more likely to be present in children aged less than 1 year than in older children (p less than 0.05, one-tailed). In the past, emphasis has been placed on corner fractures, fractures at different stages of healing, and injuries at several sites. Our results suggest that fresh single diaphyseal fractures are more common.