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Research implications

Further research is needed in the following areas:


  • There is a need for biomechanical studies focussing on the mechanism of fractures in children aged less than three years

  • Studies to date have focussed on individual bony fractures predominantly; future work would benefit from defining which combinations of fractures occur in abused and non-abused children

  • Future studies should seek to record the developmental stage of children sustaining fractures (both abusive and non-abusive)

  • Future studies should address abusive and non-abusive fractures in children with disability who have been ignored in the current literature


Rib Fractures


  • Post-mortem studies should include reflection of the pleura to ensure all fractures are accurately identified
  • There is a need for a large scale study to determine the incidence of rib fractures following two-handed CPR


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