Citation

Somers JM, Halliday KE, Chapman S. Pediatr. Radiol. 2014; 44(10): 1219-1223.

Affiliation

Radiology Department, Nottingham University Hospitals, B floor West Block, Queen's Medical Centre, Derby Road, Lenton, Nottingham, NG7 2UH, UK, jsomers@ntlworld.com.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00247-014-2954-8

PMID

24710863

Abstract

BACKGROUND: Humeral fracture in a non-ambulant infant younger than 1 year is suspicious for a non-accidental injury unless there is a credible accidental explanation. A previously unrecognised accidental mechanism was described in 1996 whereby a 5-month-old infant was rolled by a 3-year-old sibling from a prone to a supine position.

OBJECTIVE: To investigate the widely accepted view that an infant with limited mobility cannot sustain a fracture of the humerus by his or her own actions in the absence of the intervention of an external party.

MATERIALS AND METHODS: We present seven cases of non-ambulant infants between 4 and 7 months of age in whom an isolated humeral fracture was the only injury present.

RESULTS: In each case the caregiver described the fracture occurring when the child rolled over, trapping the dependent arm, without the intervention of another party.

CONCLUSION: There is no proof for this mechanism in the form of an independent witness or video recording. However, we propose that this mechanism is worthy of further consideration as a rare and unusual cause for the injury. Further study is required.

Language: en