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Child Abuse

Femur Fracture

06/16/2006

Question:

I would like to know that is it possible that a 27 days old baby (male) could receive a spiral fracture to his femur by his sibling (15 months old) by pulling him off the leather sofa at a height of 22-24 inc, the floor was carpeted. Could you please give your suggestions

Answer:

Unfortunately I cannot answer your question.  I can, however, provide you with a some information regarding spiral femur fractures.  There have been many other questions recently concerning fractures and some of the other questions/answers might be informative to you as well.

A spiral fracture requires some rotational force across the bone during the event which caused the fracture.  Sometimes it can be difficult to distinguish spiral fractures from oblique fractures and the terms may be used interchangeably.

The bones of a young infant are easier to break compared to the larger bones on older children and healthy adults. They are smaller and therefore typically require less force to break.

Young siblings may be involved in episodes with infants which cause fracture to occur.  If there was no witnessed event but speculation that the fracture was caused by a preverbal sibling, it can be very challenging for child protection workers to determine if the infant is safe at home.   

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Response by:

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