HUMERUS SHAFT FRACTURES IN YOUNG-CHILDREN - ACCIDENT OR ABUSE

We performed a retrospective review of 34 humerus shaft fractures (HSF s) in children younger than 3 years to determine the frequency of chil d abuse in young children with this injury. Data were obtained from ho spital records (including previous and subsequent emergency, clinic, a nd inpatient notes), radiographs, and county child-protective services . Cases were reviewed independently by four physicians and were classi fied as probable abuse, probable not abuse, and indeterminate. Only 18 % were classified as probable abuse. The history and findings other th an the fracture itself were critical in establishing cause. Neither ag e nor fracture pattern is pathognomonic of abuse, but suspicion should remain high. A detailed history, complete physical examination, and a ppropriate radiographic investigation are required in every case eithe r to make the diagnosis of abuse or to avoid the trauma of a false acc usation.