Fractures in physical child abuse

Fractures are regularly reported in young children who have suffered from physical abuse or neglect. Clinicians need to be aware of the epidemiology and the causes of fractures in children and have an understanding of the indicators that suggest that a fracture may have arisen from child abuse. They should be able to identify which children should be investigated to exclude child abuse and the optimal radiological investigation techniques that are currently recommended.This review identifies some of the features that can be used to differentiate abusive fractures from the greater numbers of childhood fractures that are sustained from accidental trauma. Current investigation strategies and diagnostic dilemmas are discussed.