Non-accidental injury

Case contributed by Dr Henry Knipe

Presentation

Acute onset of left lower limb swelling and redness.

Patient Data

Age: Three months
Gender: Female
x_ray

Subacute fractures of the distal tibia and distal fibula. Metaphyseal corner fracture of the proximal/medial tibia is also evident. 

Case Discussion

Fracture age that does not correspond with the history, especially in non-ambulant children should raise suspicion of non-accidental injuries. Metaphyseal corner fractures are highly suspicious, and are almost pathognomonic. 

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