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Child Abuse

Spiral Fracture Accident

05/30/2006

Question:

There is a 2 1/2yr.old in the home with no signs of abuse, in fact mother is overprotective. Mother laid baby next to father in bed, walked down hallway, baby was crying, mother walked back to bedroom and dad said he was not awake and rolled over onto baby-baby crying, mom took him to ER, ER sent her to another hospital, they kept her and baby 30 hrs and said it was a spiral fracture and removed baby from her and then took older child out of home-can it be possible for a 260lb man to roll onto child and perhaps his elbow pushed down on baby`s arm to create this fracture? Is it always instantly child abuse? Chilren`s pediatrician does not believe it is abuse, please help, I am desperate! Thank you.

Answer:

You are asking if a spiral femur fracture is always due to child abuse.  The answer to this question is no.  Spiral femur fractures can be caused by both child abuse and by accident.

The evaluation and risk assessment done by Children's Services must take into account many factors, one of which is the likelihood of accident vs abuse for a particular injury.

Other factors typically include past medical and social history, family history and assessment and specific events that took place before and after medical care is sought.  Frequently in young children, evidence of occult trauma is looked for as well.

For more information:

Go to the Child Abuse health topic, where you can:

Response by:

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