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Metaphyseal corner fractures
4%
76/1908
Spiral long bone fractures
6%
105/1908
Multiple fractures in different stages of healing
5%
103/1908
Anterior translation of the femoral neck relative to the femoral epiphysis
83%
1582/1908
Posterior rib fractures
1%
28/1908
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Anterior translation of the femoral neck relative to the femoral epiphysis best describes Slipped Capital Femoral Epiphysis (SCFE) and is not typically associated with abuse or non-accidental trauma. Fracture patterns associated with child abuse which should raise one's suspicion include: 1) metaphyseal corner fractures 2) spiral fractures 3) multiple fractures at different stages of healing 4) single transverse long bone fractures 5) posterior rib fractures 6) skull fractures King et al. found that skull fractures were the most prevalent fractures seen in battered children. Second to skull fractures were single, transverse long bone fracture in prevalence. Kemp et al. found that fractures resulting from abuse were recorded throughout the skeletal system, most commonly in infants (<1 year) and toddlers (between 1 and 3 years old). They noted that "when infants and toddlers present with a fracture in the absence of a confirmed cause, physical abuse should be considered as a potential cause. No fracture, on its own, can distinguish an abusive from a non-abusive cause".
2.1
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