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Dating fractures in infants

Abstract

Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.
Authors:
Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk; [1]  Broderick, N J; Somers, J M; [1]  Hawkes, R [2] 
  1. Department of Radiology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham (United Kingdom)
  2. Department of Radiology, Paul O'Gorman Building, Bristol (United Kingdom)
Publication Date:
Nov 15, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Clinical Radiology; Journal Volume: 66; Journal Issue: 11; Other Information: DOI: 10.1016/j.crad.2011.06.001; PII: S0009-9260(11)00218-2; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BONE FRACTURES; DATES; FRACTURES; HEALING; INFANTS; PATIENTS; RADIOLOGY; SKELETON; SWELLING; AGE GROUPS; ANIMALS; BIOLOGICAL RECOVERY; BODY; CHILDREN; DEFORMATION; DISEASES; FAILURES; FOOD; FRUITS; INJURIES; MAMMALS; MAN; MEDICINE; NUCLEAR MEDICINE; ORGANS; PRIMATES; VERTEBRATES
OSTI ID:
21584097
Country of Origin:
United Kingdom
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0009-9260; CLRAAG; TRN: GB12R0808062126
Availability:
Available from http://dx.doi.org/10.1016/j.crad.2011.06.001
Submitting Site:
GBN
Size:
page(s) 1049-1054
Announcement Date:
Aug 25, 2012

Citation Formats

Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk, Broderick, N J, Somers, J M, and Hawkes, R. Dating fractures in infants. United Kingdom: N. p., 2011. Web. doi:10.1016/j.crad.2011.06.001.
Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk, Broderick, N J, Somers, J M, & Hawkes, R. Dating fractures in infants. United Kingdom. doi:10.1016/j.crad.2011.06.001.
Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk, Broderick, N J, Somers, J M, and Hawkes, R. 2011. "Dating fractures in infants." United Kingdom. doi:10.1016/j.crad.2011.06.001. https://www.osti.gov/servlets/purl/10.1016/j.crad.2011.06.001.
@misc{etde_21584097,
title = {Dating fractures in infants}
author = {Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk, Broderick, N J, Somers, J M, and Hawkes, R}
abstractNote = {Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.}
doi = {10.1016/j.crad.2011.06.001}
journal = {Clinical Radiology}
issue = {11}
volume = {66}
place = {United Kingdom}
year = {2011}
month = {Nov}
}