Fractures caused by child abuse.

Caffey’s paper on the association between fractures of the long bones and subdural haematoma, published in 1946, was the first modern description of the consequences of child abuse, now often referred to by the euphemism ‘non-accidental injury’. Since then there have been many reports of the skeletal injuries in the radiological and paediatric literature (Caffey 1957; Kempe et al 1962; Griffiths and Moynihan 1963; Silverman 1972; Merten, Radkowski and Leonidas 1983; Ellerstein and Norris 1984; Chapman 1990; Kleinman 1990), papers describing their pathological and radiological features (Kleinman, Marks and Blackbourne 1986; Kleinman et al 1991), and articles contrasting the patterns of fractures caused accidentally and nonaccidentally (Anderson 1982; Beals and Tufts 1983; Worlock, Stower and Barbor 1986; King et al 1988; Loder and Bookout 1991 ; Thomas et al 1991). These aspects of the musculoskeletal injuries of non-accidental injury will be reviewed.