Fractures and Skeletal Injuries

Theidentification of a skeletal injury may be the first indication of abuse. Estimates of the frequency of fractures in abused children vary from approximately 10% to 50% depending on the population studied, the type of diagnostic imaging used to detect fractures, and the age of the patients seen (Ebbin, Gollub, Stein, & Wilson, 1969; Herndon, 1983; Leventhal, Thomas, Rosenfield, & Markowitz, 1993). Recently, large population-based studies have been used to estimate the incidence of inflicted skeletal trauma. While the majority of fractures are still attributed to falls, child abuse accounts for 12% of fractures in children less than 36 months of age (Leventhal, 2008).