Development and Duration of Radiographic Signs of Bone Healing in Children

Islam, Omar; Soboleski, Don; Symons, S.; Davidson, Lynne; Ashworth, MT; Babyn, Paul

doi:10.2214/ajr.175.1.1750075

Cited by 109 publications

(59 citation statements)

References 6 publications

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“…In the rare circumstance that the birth history is unclear, a useful rule is that periosteal reaction and new bone formation are radiographically evident 10-14 days following injury [11]. The corollary of this fact is that the absence of periosteal reaction and healing response at a CML site in a neonate greater than 14 days of age is suggestive of abuse.…”

Section: Discussionmentioning

confidence: 99%

Classic metaphyseal lesion following external cephalic version and cesarean section

Lysack

Soboleski

2003

Ped Radiol

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We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury.

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Section: Discussionmentioning

confidence: 99%

Classic metaphyseal lesion following external cephalic version and cesarean section

Lysack

Soboleski

2003

Ped Radiol

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“…Firstly, it is essential to accurately identify the stage of fracture healing, information that cannot be retrieved entirely from gross inspection and radiological analysis. In fact, some studies consider that the timing of fractures determined radiographically, especially in children, may be uncertain [67,68]. The determination of the posttraumatic survival interval is important not only to understand how past populations coped with injury but also because it assumes particular relevance in forensic contexts [47].…”

Section: Resultsmentioning

confidence: 99%

Below the Callus Surface: Applying Paleohistological Techniques to Understand the Biology of Bone Healing in Skeletonized Human Remains

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Keenleyside

2016

Pathobiology

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Objectives: Bone trauma is a common occurrence in human skeletal remains. Macroscopic and imaging scrutiny is the approach most currently used to analyze and describe trauma. Nevertheless, this line of inquiry may not be sufficient to accurately identify the type of traumatic lesion and the associated degree of bone healing. To test the usefulness of histology in the examination of bone healing biology, we used an integrative approach that combines gross inspection and microscopy. Materials and Methods: Six bone samples belonging to 5 adult individuals with signs of bone trauma were collected from the Human Identified Skeletal Collection from the Museu Bocage (Lisbon, Portugal). Previous to sampling, the lesions were described according to their location, morphology, and healing status. After sampling, the bone specimens were prepared for plane light and polarized light analysis. Results: The histological analysis was pivotal: (1) to differentiate between types of traumatic lesions; (2) to ascertain the posttraumatic interval, and (3) to diagnose other associated pathological conditions. Conclusion: The outer surface of a bone lesion may not give a complete picture of the biology of the tissue's response. Accordingly, microscopic analysis is essential to differentiate, characterize, and classify trauma signs.

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“…Fracture healing is a continual process with overlapping histologic stages and corresponding radiographic fi ndings, with slight Since the pediatric bone is more vascular, the hyperemic response is greater in children than adults [ 4 ]. Radiographs during this stage may show widening of the fracture gap, and the fracture becomes more ill defi ned [ 34 ]. During the reparative phase (up to 2-3 months after injury), there is rapid bone formation, and the callus begins to develop, providing temporary stabilization [ 35 ].…”

Section: Fracture Healing and Remodeling (Box 174)mentioning

confidence: 99%

“…Radiographs show callus that may be denser than the cortex, incorporation of periosteal new bone, and osseous bridging. Radiographic signs of bone healing have a wide variation in appearance and duration, with pediatric fractures generally healing twice as fast as adults [ 34 ]. The rate at which a fracture heals also depends on its location, with growth plate injuries healing faster than diaphyseal fractures.…”

Section: Fracture Healing and Remodeling (Box 174)mentioning

confidence: 99%

Skeletal Trauma: General and Unique Considerations in Children

Ranson

2014

Pediatric Orthopedic Imaging

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This chapter presents common and unusual pediatric fracture patterns and mechanisms of injury. A detailed discussion of growth cartilage injury follows a brief presentation on cartilage development, reviewing the Salter-Harris classifi cation and the Ogden extended classification. Other unique pediatric injuries including apophyseal avulsion fractures and pediatric stress fractures are also discussed. Pediatric fracture healing and remodeling and potential complications are presented. Finally, there is a brief discussion of pediatric articular trauma.The dynamic state of the developing skeleton makes children susceptible to unique mechanisms of injury, resulting in specifi c fracture patterns. Pediatric fractures may result from acute or chronic/repetitive trauma; typical mechanisms of injury include a fall, motor vehicle collision, or sporting injury. The type of fracture that occurs depends on the child's age. Fractures in infants are often diaphyseal, whereas older children commonly sustain fractures involving the metaphysis or metadiaphysis (Fig. 17.1 ) [ 1 ]. Since pediatric bone is relatively elastic, several fractures-such as greenstick, buckle, and bowing injuries-are essentially limited to children. Growth plate fractures represent up to 25 % of all pediatric fractures, and additional growth cartilage injuries include osteochondral and apophyseal fractures [ 2 , 3 ].

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Development and Duration of Radiographic Signs of Bone Healing in Children

Abstract: A wide variation exists in the appearance and duration of the radiographic signs of bone healing. Marginal sclerosis should be an expected radiographic sign of normal bone healing. Applying maximum and minimum time spans to objective radiographic signs may aid in fracture dating.

Cited by 109 publications

References 6 publications

Classic metaphyseal lesion following external cephalic version and cesarean section

Classic metaphyseal lesion following external cephalic version and cesarean section

Below the Callus Surface: Applying Paleohistological Techniques to Understand the Biology of Bone Healing in Skeletonized Human Remains

Skeletal Trauma: General and Unique Considerations in Children

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