Humeral fracture in non-ambulant infants-a possible accidental mechanism.
BACKGROUND
Humeral fracture in a non-ambulant infant younger than 1 year is suspicious for a non-accidental injury unless there is a credible accidental explanation. A previously unrecognised accidental mechanism was described in 1996 whereby a 5-month-old infant was rolled by a 3-year-old sibling from a prone to a supine position.


OBJECTIVE
To investigate the widely accepted view that an infant with limited mobility cannot sustain a fracture of the humerus by his or her own actions in the absence of the intervention of an external party.


METHODS
We present seven cases of non-ambulant infants between 4 and 7 months of age in whom an isolated humeral fracture was the only injury present.


RESULTS
In each case the caregiver described the fracture occurring when the child rolled over, trapping the dependent arm, without the intervention of another party.


CONCLUSIONS
There is no proof for this mechanism in the form of an independent witness or video recording. However, we propose that this mechanism is worthy of further consideration as a rare and unusual cause for the injury. Further study is required.
Radiology Department, Nottingham University Hospitals, B floor West Block, Queen's Medical Centre, Derby Road, Lenton, Nottingham, NG7 2UH, UK, jsomers@ntlworld.com.
John M
JM
Somers
Katharine E
KE
Halliday
Stephen
S
Chapman
D000061:Accidents, Home; D002649:Child Abuse / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000209:etiology*; D007223:Infant; D008297:Male; D011859:Radiography