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How common are rib fractures in extremely low birth weight preterm infants?


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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