Citation

Culotta PA, Burge LR, Bachim AN, Donaruma-Kwoh M. J. Forensic Leg. Med. 2020; 74: e102006.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.jflm.2020.102006

PMID

33012309

Abstract

Long bone fractures at the infant growth plate, known as classic metaphyseal lesions (CMLs), raise a strong suspicion for abusive injury. CMLs persist as a hallmark for inflicted injury although a handful of documented cases of CMLs created by other, non-abusive mechanisms within various healthcare settings are scattered throughout the past few decades of medical literature. The forces required to sustain a CML are typically defined as a combination of tensile, compressive, or rotational energy applied to the metaphyseal regions of an infant's long bones. Recently, two separate child protection teams each encountered a case of CML discovered after reported motor vehicle collisions (MVC). This provoked a critical appraisal of the medical literature to inform clinical practice regarding MVCs as a potential mechanism for this fracture type and to remind clinicians that there is no single injury pathognomonic for abuse.

Language: en

Keywords

Accidental injury; Abuse; Classic metaphyseal fractures; Motor vehicle collisions