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Long Bone Fractures

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Skeletal Atlas of Child Abuse

Part of the book series: Springer’s Forensic Laboratory Science Series ((SFLSS))

Abstract

Fractures occurring in the humerus, ulna, radius, femur, tibia, and fibula are collectively categorized as long bone fractures. Long bone fractures are further classified by type and location. Interpretation of the forces associated with the fracture depends on the location, type, and extent of the fracture. Common long bone fracture types include spiral, oblique, transverse, torus (or buckle), greenstick, and classic metaphyseal lesion (CML) [1]. A spiral fracture circles the shaft and typically results from a rotational force. An oblique fracture crosses the bone diagonal to the long axis, and a transverse fracture crosses the bone at a right angle to the long axis. A torus (or buckle) fracture, in which the cortical bone balloons out, is typically the result of a compression force loading through the long axis of the bone. A greenstick fracture is an incomplete fracture, most often an incomplete transverse fracture, and is commonly found in children as a result of the increased elasticity of the developing bone. CML is a fracture of the physeal plate of a long bone.

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References

  1. Galloway A: Broken Bones: Anthropological Analysis of Blunt Force Trauma. Springfield: Charles C. Thomas; 1999.

    Google Scholar 

  2. Kleinman PK: The upper extremity diagnostic imaging of child abuse. In Diagnostic Imaging of Child Abuse, edn 2. Edited by Kleinman PK. St. Louis: Mosby; 1998:72–109.

    Google Scholar 

  3. Kleinman PK, Marks SC: Relationship of subperiosteal bone collar to metaphyseal lesions in abuse infants. J Bone Joint Surg Am 1995, 77(10):1417–1416.

    Google Scholar 

  4. Leonidas JC: Skeletal trauma in the child abuse syndrome. Pediatr Ann 1983, 12(12):875–881.

    PubMed  CAS  Google Scholar 

  5. Worlock P, Stower M, Barbor P: Patterns of fractures in accidental and non-accidental injury in children: a comparative study Br Med J (Clin Res Ed) 1986, 293:100–102.

    Google Scholar 

  6. Pierce MC, Bertocci GE, Vogeley E, Moreland MS: Evaluating long bone fractures in children: a biomechanical approach with illustrative cases. Child Abuse Negl 2004, 28:505–524.

    Article  PubMed  Google Scholar 

  7. Johnson K: Skeletal aspects of non-accidental injury. In Calcium and Bone Disorders in Children and Adolescents. Edited by Allgrove J, Shaw NJ. Endocr Dev, vol 16. Basel: Karger; 2009:233–245.

    Google Scholar 

  8. Kleinman PK, Marks SC, Blackbourne B: The metaphyseal lesion in abused infants: a radiologic-histopathological study. AJR Am J Roentgenol 1986, 146:895–905.

    PubMed  CAS  Google Scholar 

  9. Kleinman PK, Marks SC: A regional approach to classic metaphyseal lesions in abused infants: the distal tibia. AJR Am J Roentgenol 1996, 166:1207–1212.

    PubMed  CAS  Google Scholar 

  10. Kleinman PK, Marks SC, Richmond JM, Blackbourne BD: Inflicted skeletal injury: a postmortem radiologic-histopathologic study in 31 infants. AJR Am J Roentgenol 1995, 165:647–650.

    PubMed  CAS  Google Scholar 

  11. Caffey J: Some traumatic lesions in growing bones other than fractures and dislocations: clinical and radiological features. Br J Radiol 1957, 30:225–238.

    Article  PubMed  CAS  Google Scholar 

  12. Lonergan GJ, Baker AM, Morey MK, Boos SC: From the archives of the AFIP. Child abuse: radiologic-pathologic correlation. Radiographics 2003, 23(4):811–845.

    Article  PubMed  Google Scholar 

  13. Salter RB, Harris WR: Injuries involving the epiphyseal plate. J Bone Joint Surg Am 1963, 45:587–622.

    Google Scholar 

  14. Kleinman PK: Skeletal trauma: general considerations. In Diagnostic Imaging of Child Abuse, edn 2. Edited by Kleinman PK. St. Louis: Mosby; 1998:72–109.

    Google Scholar 

  15. Jones JCW, Feldman KW, Bruckner JD: Child abuse in infants with proximal physeal injuries of the femur. Pediatr Emerg Care 2004, 20(3):157–161.

    Article  PubMed  Google Scholar 

  16. Thomas SA, Rosenfield NS, Leventhal JM, Markowitz RL: Long-bone fractures in young children distinguishing accidental injuries from child abuse. Pediatrics 1991, 88(3):471–476.

    PubMed  CAS  Google Scholar 

  17. Taitz J, Moran K, O’Meara M: Long bone fractures in children under 3 years of age: is abuse being missed in Emergency Department presentations? J Paediatr Child Health 2004, 40:170–174.

    Article  PubMed  CAS  Google Scholar 

  18. Rex C, Kay PR: Features of femoral fractures in nonaccidental injury. J Pediatr Orthop 2000, 20(3):411–413.

    Article  PubMed  CAS  Google Scholar 

  19. Kemp AM, Dunstan F, Harrison S, et al.: Patterns of skeletal fractures in child abuse: systematic review. BMJ 2008, 377:a1518.

    Article  Google Scholar 

  20. Skellern CY, Wood D, Murphy A, Crawford M: Non-accidental fractures in infants: risk of further abuse. J Paediatr Child Health 2000, 36:590–592.

    Article  PubMed  CAS  Google Scholar 

  21. Loder RT, Bookout C: Fracture patterns in battered children. J Orthop Trauma 1991, 5(4):428.

    Article  PubMed  CAS  Google Scholar 

  22. Strait RT, Siegel RM, Shapiro RA: Humeral fractures without obvious etiologies in children less than 3 years of age: when is it abuse? Pediatrics 1995, 96(4): 667–617.

    PubMed  CAS  Google Scholar 

  23. Kocher MS, Kasser JR: Orthopaedic aspects of child abuse. Am Acad Orthop Surg 2000, 8(1):10–20.

    CAS  Google Scholar 

  24. 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 

  25. Loder RT, Feinberg JR: Orthopaedic injuries in children with nonaccidental trauma: demographic and incidence from the 2000 Kids’ Inpatient Database. J Pediatr Orthop 2007, 27(4):421–426.

    Article  PubMed  Google Scholar 

  26. Schwend RM, Werth C, Johnston A: Femur shaft fractures in toddlers and young children: rarely from child abuse. J Pediatr Orthop 2000, 20(4):475–481.

    Article  PubMed  CAS  Google Scholar 

  27. Coffey C, Haley K, Hayes J, Groner JI: The risk of child abuse in infants and toddlers with lower extremity injuries. J Pediatr Surg 2005, 40:120–123.

    Article  PubMed  Google Scholar 

  28. King J, Diefendorf D, Apthorp J, et al.: Analysis of 429 fractures in 189 battered children. J Pediatr Orthop 1988, 8:585–589.

    PubMed  CAS  Google Scholar 

  29. Beals RK, Tufts E: Fractured femur in infancy: the role of child abuse. J Pediatr Orthop 1983, 3:583–586.

    Article  PubMed  CAS  Google Scholar 

  30. Arkader A, Friedman JE, Warner WC, Wells L: Complete distal femoral metaphyseal fractures: a harbinger of child abuse before walking age. J Pediatr Orthop 2007, 27(7):751–753.

    Article  PubMed  Google Scholar 

  31. Rewers A, Hedegaard H, Lezotte D, et al.: Childhood femur fractures, associated injuries, and sociodemographic risk factors: a population-based study. Pediatrics 2005, 115(5):543–552.

    Article  Google Scholar 

  32. Caviglia H, Garrido CP, Palazzi FF, Meana NV: Pediatric fractures of the humerus. Clin Orthop Relat Res 2005, 432:49–56.

    Article  PubMed  Google Scholar 

  33. Hymel KP, Jenny C: Abusive spiral fractures of the humerus: a videotaped exception. Arch Pediat Adolesc Med 1996, 150:226–227.

    CAS  Google Scholar 

  34. Shaw BA, Kelleen MM, Shaw A, et al.: Humeral shaft fractures in young children: accident or abuse? J Pediatr Orthop 1997, 17(3):293–297.

    Article  PubMed  CAS  Google Scholar 

  35. Mellick LB, Ressor K: Spiral tibial fractures of children: a commonly accidental spiral long bone fractures. Am J Emerg Med 1990, 8:234–237.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Forensic Anthropology Division, Harris County Institute of Forensic Sciences, Houston, Texas, USA

    Jennifer C. Love PhD (Forensic Anthropology Director), Sharon M. Derrick PhD (Agency Coordinator/Forensic Anthropologist) & Jason M. Wiersema PhD (Forensic Anthropologist/Disaster Preparedness Coordinator)

Authors
  1. Jennifer C. Love PhD
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  2. Sharon M. Derrick PhD
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  3. Jason M. Wiersema PhD
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Correspondence to Jennifer C. Love PhD .

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Love, J.C., Derrick, S.M., Wiersema, J.M. (2011). Long Bone 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_5

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  • DOI: https://doi.org/10.1007/978-1-61779-216-8_5

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-61779-215-1

  • Online ISBN: 978-1-61779-216-8

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