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How common are rib fractures in extremely low birth weight preterm infants?
  1. D Smurthwaite1,
  2. N B Wright2,
  3. S Russell3,
  4. A J Emmerson4,
  5. M Z Mughal1
  1. 1
    Paediatric Medicine, St. Mary’s Hospital for Women and Children, Manchester, UK
  2. 2
    Paediatric Radiology, Royal Manchester Children’s Hospital, Manchester, UK
  3. 3
    Perinatal & Paediatric Radiology, St. Mary’s Hospital for Women and Children, Manchester, UK
  4. 4
    Neonatal Medicine, St. Mary’s Hospital for Women and Children, Manchester, UK
  1. Zulf Mughal, Consultant Paediatrician & Honorary Senior Lecturer in Child Health, Department of Paediatrics, Saint Mary’s Hospital for Women & Children, Hathersage Road, Manchester, M13 0JH UK; zulf.mughal{at}


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 the 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 (⩽1000 g) 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: The possibility of NAI should be considered in ex-ELBW infants found to have rib fractures.

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  • Competing interests: None declared.

  • Ethics approval: The study was approved by the Central Manchester Local Research Ethics Committee [Ref. No. 03/CM/343].