Table 8.

Fracture sites in nonaccidental trauma (NAT)

Reference	Study description	Age of patients	Fracture site	Caused by NAT (%)	Comments
Bulloch et al. [7]	Case series of 39 subjects; 1994–1997	1 year	Ribs	82%
Leventhal et al. [27]	Incidence of fractures in hospitalized children resulting from abuse; used Kids’ Inpatient Database	< 36 months	Ribs	61.4%
			Tibia/fibula	31.1%
			Radius/ulna	29.8%
			Clavicle	20.7%
			Skull	12.1%
			Femur	11.7%
			Humerus	9.3%
Loder and Bookout [31]	Case study of 154 fractures in 75 children reported to child protective services 1987–1988	< 7 years	Skull
			Rib
			Long bones
			“Corner” fractures
Loder et al. [32]	Case series based on 2000 Health Care Cost and Utilization Project	< 2 years	Femur	15%	n = 1076 femur fractures
Pandya et al. [38]	Analysis of trauma at a Level I pediatric trauma Center		Non-bony head injury		5 most common injuries in NAT
			Rib fracture
			Tibia/fibula fracture
			Radius/ulna fracture
			Clavicle fracture
Scherl et al. [41]	Retrospective review of 214 femur fractures	< 6 years	Femur	8%	No difference in the number of spiral and transverse fractures in abuse group