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Other useful references

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


  • The table in this oft-quoted source is derived from personal clinical experience of the authors, and has not been further validated by any primary research 1
  • No primary evidence was found to confirm faster fracture healing in infants 1
  • Repeat skeletal survey may aid in fracture dating 2
  • Bone scans have no place in fracture dating as they become positive within seven hours and can remain positive for up to one year 3
  • Study of animal models for dating rib fractures 4
  • A small study of cone-beam CT on post-mortem specimens suggested that this may be an accurate estimate of the age of the fracture 5
  • A study comparing whole body magnetic resonance imaging (WB-MRI) with skeletal survey noted that WB-MRI provided little information regarding fracture age 6

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  1. Kleinman PK. Diagnostic imaging of child abuse. 2nd ed. St Louis: Mosby, 1998 [Link to book details]
  2. Kleinman PK, Nimkin K, Spevak MR, Rayder SM, Madansky DL, Shelton YA, Patterson MM. Follow-up skeletal surveys in suspected child abuse. American Journal of Roentgenology. 1996;167(4):893-896 [Pubmed]
  3. Rosenthall L, Hill RO, Chuang S. Observation on the use of 99mTc-phosphate imaging in peripheral bone trauma. Radiology. 1976;119:637-641 [Pubmed]
  4. Zumwalt RE, Fanizza-Orphanos AM. Dating of healing rib fractures in fatal child abuse. Advanced Pathology. 1990;3:193-205
  5. Cappella A, Amadasi A, Gaudio D, Gibelli D, Borgonovo S, Di Giancamillo M, Cattaneo C. The application of cone-beam CT in the aging of bone calluses: a new perspective? International Journal of Legal Medicine. 2013;127(6):1139-44 [Pubmed]

  6. Perez-Rossello JM, Connolly SA, Newton AW, Zou KH, Kleinman PK. Whole-body MRI in suspected infant abuse. American Journal of Roentgenology. 2010;195(3):744-750 [Pubmed]


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