Dating fractures in adults

dating fractures in adults

Can fracture dating guide radiologists in the setting of suspected abuse?

To date, there has been little scientific data available to guide radiologists in fracture dating in the setting of suspected abuse, and radiologists have traditionally relied on personal experience and conventional wisdom.

Why is it important to determine the age of a fracture?

It is often crucial for forensic reasons to estimate when chronic or remote fractures may have occurred. Radiologically, an older chronic fracture will show callus at the fracture site, and possibly residual SPNBF separated from the bony cortex.

What is the customary approach to the study of fracture healing?

The customary approach to the study of the healing process of inflicted injuries is to draw upon the existing knowledge base of the biomechanics, imaging, and histopathology of accidental injury. While this is somewhat applicable, the essential differences that pertain to abusive fractures must be considered.

Which age groups have the highest prevalence of skeletal injuries?

Inflicted skeletal injuries are more common in younger children, and are most frequent in infants ( 15 –18). Fractures of abuse are unusual in children older than four years. There are inherent differences in the composition of the infant skeleton that dictate observed patterns of radiologic and histologic healing.

What is the evidence for radiologic dating of fractures?

Radiologic dating of fractures is an inexact science. Most radiologists date fractures on the basis of their personal clinical experience, and the literature provides little consistent data to act as a resource.

Is there a scientific basis for fracture dating in abuse cases?

While some scientific studies have been published on fracture dating in general, prior reports have shortcomings that limit the applicability of data to cases of abuse ( 3, 4, 6, 10, 32 –34). Inflicted skeletal injuries are more common in younger age groups and most frequent in infants ( 15 –18).

Can a bone scan be used to date a fracture?

No details were given as to what specific features were used for dating in this study. Bone scans have no place in fracture dating because they show positive results within 7 hr of injury [33] and can continue to show positive results for as long as 1 year.

How is the date of a fracture in children determined?

Dating of fractures in children is an inexact science. The radiologic features of bone healing are a continuum, with considerable overlap. Radiologic estimates of the time of injury are made in terms of weeks rather than days. It is vital for all investigating agencies to be aware of these broad time frames.

What is the prevalence of fall injuries among older adults?

The percentage of older adults who reported a fall injury also increased with age (p<0.01), from 9.9% among persons aged 65–74 years to 11.4% among persons aged 75–84 years, to 13.5% among persons aged ≥85 years. AI/ANs were more likely to report a fall-related injury (16.8%) than were whites (10.9%), Hispanics (10.7%), and blacks (7.8%).

How common are musculoskeletal conditions and injuries?

Musculoskeletal conditions and injuries are not just conditions of older age – they are prevalent across the life-course. Between one in three and one in five people (including children) live with a painful and disabling musculoskeletal condition.

Which occupational groups have the highest incidence of back injuries?

Two occupational groups accounted for more than 54% of back injury cases: operators, fabricators, and laborers (38%); and precision production, craft, and repair (17%) 7 Data from scientific studies of primary and secondary interventions indicate that low back pain can be reduced by: Engineering controls (e.g., ergonomic workplace redesign)

What is the average age of injury in the United States?

The average age at injury has increased from 29 years during the 1970s to 43 since 2015. Vehicle crashes are the most recent leading cause of injury, closely followed by falls; acts of violence (primarily gunshot wounds); and sports/recreation activities are also relatively common causes.

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