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BATTERED OR NOT—A REAPPRAISAL OF METAPHYSEAL FRAGILITY

H. G. HILLER M.D., M.R.A.C.P., D.D.R., F.C.R.A.1

1 Director of Radiology.

It is suggested that multiple epiphyseal plate fractures, up to the present considered to be almost certain evidence of battering, may in fact be due to an underlying bone defect.

The evidence for this is:

(1) A dense "chalky" texture of all bones in this series of 5 patients.

(2) The absence of this type of fracture in a review of 145 consecutive cases of fractures in the correct age group reviewed at this hospital.

(3) The difficulty in explaining why these epiphyseal plate fractures should occur on both sides of a joint if the bone structure is normal.

(4) The often apparently normal home environment in many of these patients.

(5) The findings that suggest the existence of a collagen abnormality in the bone when microscopic sections were viewed with polarized light.


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