Dating fractures in infants

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 l...

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Bibliographic Details
Published in:Clinical radiology 2011-11, Vol.66 (11), p.1049-1054
Main Authors: Halliday, K.E, Broderick, N.J, Somers, J.M, Hawkes, R
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child, Preschool
Female
Femoral Fractures - diagnostic imaging
Femoral Fractures - physiopathology
Fracture Healing
Humans
Humeral Fractures - diagnostic imaging
Humeral Fractures - physiopathology
Infant
Infant, Newborn
Injuries of the limb. Injuries of the spine
Male
Medical sciences
Observer Variation
Radiography
Radiology
Radius Fractures - diagnostic imaging
Radius Fractures - physiopathology
Retrospective Studies
Tibial Fractures - diagnostic imaging
Tibial Fractures - physiopathology
Time Factors
Traumas. Diseases due to physical agents
Ulna Fractures - diagnostic imaging
Ulna Fractures - physiopathology
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Summary: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.
ISSN:0009-9260
1365-229X
DOI:10.1016/j.crad.2011.06.001