Fractures in infants: a sign of child abuse.

Fractures occurring in children under one year of age were reviewed retrospectively. Forty-nine such patients presented to the emergency department at Children's Hospital of Michigan in 1978. Twenty-two of these fractures were thought to represent physical abuse. Physical abuse was considered when: 1) the history was incompatible, discrepant, variable or unexplained; 2) associated physical findings were present; 3) unusual fractures were present; 4) there was a known history of previous abuse/neglect; 5) there had been delay in seeking medical aid. A suggested method of dealing with this particular type of patient is presented.