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Child Abuse

Spiral Fracture While Changing A Diaper

11/16/2006

Question:

I am asking about the possibility of a spiral fracture to the femur. The scenario is that the 3 year old is having his diaper changed. The sitter says that the child would not hold still and while trying to subdue the child while raising and pushing on the child`s legs to move them back to change the diaper, there was a pop. The result was a break in the upper femur. Is this scenario possible? Would extreme force have had to be used? Could the movement of the child one way and the puhing the legs up create such a fracture?

Answer:

It is possible to fracture the femur during diaper changes and for the fracture to be spiral in nature.

Unless your child has some type of bone fragility, this fracture should not have occurred and would require significant force.  It is probably appropriate, whether child abuse is proven or not, to change child care providers. 

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Response by:

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