Citation

Barsness KA, Cha ES, Bensard DD, Calkins CM, Partrick DA, Karrer FM, Strain JD. J. Trauma 2003; 54(6): 1107-1110.

Affiliation

Department of Surgery, The Children's Hospital, University of Colorado Health Sciences Center, Denver, USA. katherine.barsness@uchsc.edu

Copyright

(Copyright © 2003, Lippincott Williams and Wilkins)

DOI

10.1097/01.TA.0000068992.01030.A8

PMID

15128154

Abstract

BACKGROUND: Rib fractures have a strong association with nonaccidental trauma (NAT) and severe trauma. The purposes of this study were to evaluate rib fractures in children to determine (1) the positive predictive value of a rib fracture in defining NAT and (2) the frequency of rib fractures as the only skeletal manifestation of NAT. METHODS: We reviewed the medical records and imaging of all children with rib fractures over a 6-year period. NAT was determined by the Child Advocacy and Protection team. RESULTS: In children younger than 3 years of age, the positive predictive value (PPV) of a rib fracture as an indicator of NAT was 95%. The positive predictive value increased to 100% once historical and clinical circumstance excluded all other causes for rib fractures. CONCLUSION: In this study, rib fracture(s) were the only skeletal manifestation of NAT in 29% of the children.