Skip to main content

Rib Fractures

  • Chapter
  • First Online:
Book cover Skeletal Atlas of Child Abuse

Abstract

Rib fractures are recognized as strong indicators of nonaccidental injury in infants and children and are more prevalent than any other type of skeletal injury in cases classified as child abuse [1–13]. They remain strong indicators of nonaccidental injury in older ­children (>18 months) when other types of fractures become more prevalent with accidental injury [1]. Several researchers have found that the average number of rib fractures is significantly higher in cases of nonaccidental injury than in those of accidental injury and that rib fractures often are the only skeletal injury observed in cases classified as child abuse [1, 2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pandya NK, Baldwin K, Wolfgruber H, et al.: Child abuse and orthopaedic injury patterns: analysis at a level 1 pediatric trauma center. J Pediatr Orthop 2009, 28(6):618–625.

    Google Scholar 

  2. Bulloch B, Schubert CJ, Brophy PD, et al.: Cause and clinical characteristics of rib fractures in infants. Pediatrics 2000, 105(4):E48.

    Article  PubMed  CAS  Google Scholar 

  3. Barsness KA, Cha E, Bensard DD, et al.: The positive predictive value of rib fractures as an indicator of nonaccidental trauma in children. J Trauma 2003, 54(6):1107–1110.

    Article  PubMed  Google Scholar 

  4. Spevak MR, Kleinman PK, Belanger PL, et al.: Cardiopulmonary resuscitation and rib fractures in infants: a postmortem radiologic-pathologic study. JAMA 1994, 272(8):617–618.

    Article  PubMed  CAS  Google Scholar 

  5. Garcia VF, Gotschall CS, Eichelberger MR, Lowman LM: Rib fractures in children: a marker of severe trauma. J Trauma 1990, 30(6):695–700.

    Article  PubMed  CAS  Google Scholar 

  6. Feldman KW, Brewer DK: Child abuse, cardiopulmonary resuscitation, and rib fractures. Pediatrics 1984, 73(3):339–342.

    PubMed  CAS  Google Scholar 

  7. Kleinman PK, Marks SC, Nimkin K, et al.: Rib fractures in 31 abused infants: postmortem radiologic-histopathologic study Radiology 1996, 200:807–810.

    PubMed  CAS  Google Scholar 

  8. Kleinman PK, Schlesinger AE: Mechanical factors associated with posterior rib fractures: laboratory and case studies. Pediatr Radiol 1997, 27:87–91.

    Article  PubMed  CAS  Google Scholar 

  9. Mandelstam SA, Cook D, Fitzgerald M, Ditchfield MR: Complementary use of radiological skeletal survey and bone scintigraphy in detection of bony injuries in suspected child abuse. Arch Dis Child 2003, 88(5):387–390.

    Article  PubMed  CAS  Google Scholar 

  10. Smeets AJ, Robben SGF, Meradji M: Songraphically detected costo-chondral dislocation in an abused child: a new ­sonographic sign to the radiological spectrum of child abuse. Pediatr Radiol 1990, 20:566–567.

    Article  PubMed  CAS  Google Scholar 

  11. Gunter WM, Symes SA, Berryman HE: Characteristics of child abuse by anteroposterior manual compression versus cardiopulmonary resuscitation: case report. Am J Forensic Med Pathol 2000, 21(1):5–10.

    Article  Google Scholar 

  12. Maguire S, Mann M, John N, et al.; Welsh Child Protection Systematic Review Group: Does cardiopulmonary resuscitation cause rib fractures in children? A systematic review. Child Abuse Negl 2006, 30(7):739–751.

    Article  PubMed  Google Scholar 

  13. Dolinak D: Rib fractures in infants due to cardiopulmonary resuscitation efforts. Am J Forensic Med Pathol 2007, 28(2):107–110.

    Article  PubMed  Google Scholar 

  14. Cadzow SP, Armstrong KL: Rib fractures in infants: red alert! The clinical features, investigations and child protection outcomes. J Paediatr Child Health 2000, 36:322–326.

    Article  PubMed  CAS  Google Scholar 

  15. Weber MA, Risdon RA, Offiah AC, et al.: Rib fractures identified at post-mortem examination in sudden unexpected deaths in infancy (SUDI) Forensic Sci Int 2009, 189(1–3):75–81.

    Article  PubMed  Google Scholar 

  16. Kleinman PK: Bony thoracic trauma. In Diagnostic Imaging of Child Abuse, edn 2. Edited by Kleinman PK. St. Louis: Mosby; 1998:110–148.

    Google Scholar 

  17. Worn MJ: Rib fractures in infancy: establishing the mechanisms of cause from the injuries—a literature review. Med Sci Law 2007, 47:200–212.

    Article  PubMed  CAS  Google Scholar 

  18. Betz P, Liebhardt E: Rib fractures in children—resuscitation or child abuse? Int J Legal Med 1994, 106:215–218.

    Article  PubMed  CAS  Google Scholar 

  19. Schweich P, Fleisher G: Rib fractures in children. Pediatr Emerg Care 1985, 1(4):187–189.

    Article  PubMed  CAS  Google Scholar 

  20. Ng CS, Hall CM: Costochondral junction fractures and intra-abdominal trauma in non-accidental injury (child abuse). Pediatr Radiol 1998, 28:671–676.

    Article  PubMed  CAS  Google Scholar 

  21. American Heart Association in collaboration with the International Liaison Committee on Resuscitation (ILCOR): Guidelines 2000 for cardiopulmonary resuscitation and ­emergency cardiovascular care: an international consensus on science. Resuscitation 2000, 46:1–447.

    Google Scholar 

  22. Strouse PJ, Owings CL: Fractures of the first rib in child abuse Radiology 1995, 197:763–765.

    CAS  Google Scholar 

  23. Vikramaditya PP: Two cases of isolated first rib fractures. Emerg Med J 2001, 18:498–499.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jennifer C. Love PhD .

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Love, J.C., Derrick, S.M., Wiersema, J.M. (2011). Rib Fractures. In: Skeletal Atlas of Child Abuse. Springer’s Forensic Laboratory Science Series. Humana Press. https://doi.org/10.1007/978-1-61779-216-8_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-61779-216-8_3

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-61779-215-1

  • Online ISBN: 978-1-61779-216-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics