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a skeletal survey to rule out other fractures.
96%
693/723
a punch biopsy of the skin for collagen analysis to rule out osteogenesis imperfecta.
1%
6/723
DNA testing for osteogenesis imperfecta.
2%
11/723
blood studies for calcium, phosphorus, and alkaline phosphate levels.
7/723
blood studies for parathyroid hormone levels.
0%
1/723
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Unwitnessed spiral fractures should raise the possibility of child abuse, especially prior to walking age. With nonaccidental trauma being considered in the differential diagnosis, a skeletal survey is indicated to determine if there are other fractures in various stages of healing.
4.2
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