Orthopaedic aspects of child abuse

Child abuse is a common, serious problem. Diagnosis of nonaccidental injury can be challenging for orthopaedists because there are no fractures that are pathognomonic for abuse. There are high- and low-specificity fracture patterns for abuse, however, and these can be used to guide clinical diagnosis along with the history, physical examination, and radiographic and laboratory studies. A multidisciplinary approach to evaluation, treatment, and reporting should be considered.