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Updated: Dec 26, 2025
Assessment of Bone Fracture Healing Using Micro-Computed Tomography
Published on: December 9, 2022
Radiographic timelines for pediatric healing fractures: a systematic review
Diana L Messer1,2, Brent H Adler3,4, Farah W Brink3,5
1Department of Biomedical Education and Anatomy,Division of Anatomy,College of Medicine, The Ohio State University, Columbus, OH, USA. dianamesser@gmail.com.
Insights
Pediatric fracture healing timelines are not well-established in scientific literature. Existing data on child fracture healing varies significantly, requiring cautious interpretation in clinical and forensic evaluations.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Forensic Pathology
Background:
- Skeletal fractures are common in physically abused children.
- These fractures are often undiagnosed or treated late.
- Radiographic incidental findings are a common discovery method.
Purpose of the Study:
- To review scientific literature on pediatric fracture healing timelines.
- To evaluate the quality of existing studies for clinical and forensic use.
- To identify gaps in current knowledge.
Main Methods:
- Comprehensive literature search of Embase, EBSCOhost, MEDLINE (PubMed), and Web of Science.
- Inclusion criteria focused on scientific, radiographic studies of pediatric fracture healing.
- Quality assessment of 313 full-text articles, with 10 meeting inclusion criteria.
Main Results:
- Studies included patients aged 0-17 years, with a focus on infants.
- Fracture locations primarily involved the upper limb, pectoral girdle, and lower limb.
- Significant variation was observed in radiographic healing features and timelines across studies.
Conclusions:
- Scientific, radiographic studies on pediatric fracture healing are limited.
- Gaps in knowledge necessitate future research and validation studies.
- Existing fracture healing timelines should be used with caution due to variability.
Abstract:
Skeletal fractures, a common injury in physically abused children, often go undetected and untreated for significant lengths of time and are sometimes incidentally discovered radiographically. Our objective was to review current literature for scientific studies of pediatric fracture healing with associated timelines. We conducted a search of Embase, EBSCOhost, MEDLINE (PubMed), and Web of Science for literature published from the earliest available up to August 2018. We evaluated the included articles for quality, with consideration for use in clinical and forensic settings. Of a total of 313 full-text articles evaluated, 10 met study inclusion criteria. The patient age range among studies was 0-17 years, with children younger than 1 year included in the majority of studies. The fracture locations included in studies were primarily fractures of the upper limb and pectoral girdle, followed by fractures of the lower limb. The radiographic features of healing varied greatly among the studies. Timelines of common fracture healing variables differed significantly among studies. Scientific, radiographic studies of pediatric fracture healing are limited. Gaps in knowledge regarding fracture healing highlight the need for future research and validation studies. Fracture healing timelines derived from existing timelines should be used with caution.
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