This Week In The Bmj

Childhood fractures don't often cause bruising

BMJ 1998; 317 doi: (Published 24 October 1998) Cite this as: BMJ 1998;317:d

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.