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Child Abuse

Causes of Bone Fractures

03/20/2006

Question:

Is it possible for a 4 month old to have two fractures one of which is about 2 weeks old both caused by accident. There were no symptoms of the first fracture and the only obvious one for the second was that the child could not move his leg. The baby was born 1 month prematurely. Could the injuries have been caused by his 5 year old brother leaning on him? Could it have been caused when he was swaddled?

Answer:

Fractures in young infants can be accidental or abusive in nature.  Many times, because the babies don't ambulate on their own, we discover that the fractures were caused by a caretaker.  Often a diagnosis of abuse is made.

Having more than one fracture is an additional indication that something serious is amiss.  It may be abuse, serious neglect or some medical condition that causes bone fragility.

1 month premature is not typically a significant risk factor for increased fracture potential.  Fractures can of course be caused by the actions of an adult or a child.  Swaddling would not be expected to cause fractures in a healthy infant.

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Response by:

Robert Shapiro, MD
Professor of Clinical Pediatrics
College of Medicine
University of Cincinnati