Dating rib fractures in infants
The eleventh rib fracture shows no healing. Increased radiodensity projecting into the soft tissues adjacent to the fracture margin is noted, consistent with early soft callus formation large arrows. Provisional calcification and invasion of cartilage by metaphyseal vessels proceed normally.
This may take place over a period as long as one to two years following the initial injury. Greater force increases the risk for organ damage. It is not intended as medical advice for individual conditions or treatments.
As active hemorrhage ceases, a hematoma is formed. Always read the medicine label and follow directions. Uninjured cartilage cells proliferate, with a relatively rapid increase in the number of chondrocytes per column. The birth-related clavicular fracture was deemed an appealing surrogate for inflicted injury, as fracture age at the time of injury is known with reasonable certainty. Cartilage formation occurs predominantly at the periphery of the callus, and conversion to bone proceeds through enchondral ossification.
While this is somewhat applicable, the essential differences that pertain to abusive fractures must be considered. The response to physeal injury is much quicker than that to fractures of cancellous or cortical bone. In cases of abuse, clinical history may be absent or misleading.
The timing of repetitive injuries and the severity of each incident may be widely variable. Resorption of these tissues occurs in preparation for the constructive phase of repair. Two of the variables affecting abuse-related fractures, lack of immobilization and repetitive trauma, do not generally pertain to these obstetric injuries. The timetable of fracture healing is known to be quite different in these age groups. There is a healing fracture of the right tenth rib circle.
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