title: Dating fractures in infants.
abstract: OBJECTIVE
  To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement.
  
  
  METHODS
  Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus.
  
  
  RESULTS
  Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days.
  
  
  CONCLUSIONS
  With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.
authors.affiliation: Department of Radiology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK. kath.halliday@nuh.nhs.uk
authors.forename: K E
authors.initials: KE
authors.lastname: Halliday
authors.forename: N J
authors.initials: NJ
authors.lastname: Broderick
authors.forename: J M
authors.initials: JM
authors.lastname: Somers
authors.forename: R
authors.initials: R
authors.lastname: Hawkes
mesh_terms: D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors; D014458:Ulna Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology