Bone Fracture Essay

955 WordsMay 27, 20124 Pages
The ability of physicians to identify and date fractures was greatly enhanced by advances in the use and interpretation of X-rays. By employing X-ray technology, pediatric radiologists are able to tell approximately when a fracture occurred and often what type of force caused the fracture. By comparing this information with the caretaker's explanation of an injury the physician can often identify cases of suspected abuse. While certain types of fractures are indicative of abuse, a diagnosis of abuse requires information about the child's environment, how the injury occurred, the child's caretakers and medical history. Some childhood diseases can render the bones brittle and thus more susceptible to injury. Conditions such as osteogenesis imperfecta and congenital insensitivity to pain must be ruled out in the process of diagnosing child abuse. It is not uncommon for infants, particularly breech deliveries, to sustain fractures during childbirth. As a general rule, fractures incidental to childbirth will be visible on X-rays by the 11th day of life. Bone trauma appearing after this time is assumed to have occurred following birth. In evaluating the possibility of child battering, consideration of the child's age is important. While it is quite possible for a child to sustain certain types of fractures while learning to walk, the presence of a transverse (crosswise) or spiral fracture in a child who is not yet able to walk may arouse suspicion. Bone fractures related to child abuse are caused by a direct blow, twisting (usually of a limb), shaking or squeezing. The particular kind of force used may produce a characteristic type of fracture. A direct blow often produces a transverse or spiral fracture to the shaft of a long bone. Blows to the head often produce internal injuries in addition to fractures of the cranium, mandible and maxillary bones. Swelling due

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