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Arch Dis Child Fetal Neonatal Ed doi:10.1136/adc.2007.136853

How Common Are Rib Fractures In Extremely Low Birth Weight Preterm Infants?

  1. Denise Smurthwaite (denise.smurthwaite{at}cmmc.nhs.uk)
  1. St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom
    1. Neville Wright (neville.wright{at}cmmc.nhs.uk)
    1. Royal Manchester Children’s Hospital, Manchester M27 4HA, United Kingdom
      1. Sarah Russell (sarah.russell{at}cmmc.nhs.uk)
      1. St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom
        1. Anthony Emmerson (anthony.emmerson{at}cmmc.nhs.uk)
        1. St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom
          1. Zulf Mughal (zulf.mughal{at}cmmc.nhs.uk)
          1. St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom
            • Published Online First 6 August 2008

            Abstract

            Background: This study was prompted by incidental finding of healing rib fractures on chest radiographs of ex-preterm born infants, who were admitted to hospital with acute respiratory illnesses within a few weeks of discharge from neonatal Intensive care unit (NICU). Rib fractures in infants, particularly those situated posteriorly, are considered to be specific for non-accidental injury (NAI).

            Methods: Retrospective examination of radiographs of extremely low birth weight (ELBW) infants (≤1000g) with a gestation range of 22 of 33 weeks, cared for at a tertiary NICU, between 1998 and 2002, and who had survived ≥4 weeks.

            Results: Five out of 72 (7%) infants studied had radiologically apparent rib fractures. None involved posterior rib shafts. All infants with rib fractures died on the NICU.

            Conclusions: We conclude that the possibility of NAI should to be considered in ex-ELBW infants found to have rib fractures.

            considered, irrespective of a neonatal history of prematurity.

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