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CML Fractures in NAI — RACP Paediatrics MCQ

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HardEmergency PaediatricsCML Fractures in NAIRACP Paediatrics

A child with suspected non-accidental injury has a skeletal survey performed. What is the most specific fracture pattern for inflicted injury in an infant?

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Correct answer: D — Classic metaphyseal lesions (corner fractures/bucket handle fractures)

Classic metaphyseal lesions (CMLs / bucket handle / corner fractures) are highly specific for inflicted injury and result from shearing forces applied to the metaphysis during violent shaking or pulling of limbs. Other highly suspicious fractures include posterior rib fractures, scapular fractures, and multiple fractures at different healing stages.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Physical Abuse