Most often, the subdural hemorrhages will demonstrate varying ages.Fractures in children younger than 18 months occur before the usual walking age.Bone scans are also able to detect radiographically occult fractures and should be considered when clinical suspicion is high. Rib fractures are easily missed so current practice is to repeat chest films in 2 weeks to observe for any healing rib fractures.
The study included 192 children with inflicted fractures.
Rib fractures also were associated uncommonly with bruising.
When skull fractures are excluded, 45 (8.1%) of 555 fractures had bruising near the fracture site, in 13 (6.8%) patients.
Diaphyseal fractures are easy to recognise, whereas challenges may arise with the diagnosis of physeal injuries.
Fractures occurring after the neonate is discharged home may be due to accidental falls related to clumsiness on the part of the carers.
Other possibilities, however, are child abuse and abnormal bone fragility.