Childhood fractures don't often cause bruising

Childhood fractures without bruising often lead to a suspicion of osteogenesis imperfecta or metabolic bone disease and deflect attention from non-accidental injury. Mathew et al's prospective study of 93 acute fractures shows that only 8 fractures showed bruising at presentation (p 1117); bruising did not occur initially in fractures that were undisplaced or well covered by soft tissue. The authors conclude that the absence of bruising is an unreliable sign on which to base a diagnosis of non-accidental injury.


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Relevant Article

Importance of bruising associated with paediatric fractures: prospective observational study

M O Mathew, N Ramamohan, and G C Bennet
BMJ 1998 317: 1117-1118. [Full Text] [PDF]