Posterior Rib Fracture
Definition
A fracture at the posterior rib near the costotransverse junction. Produced by forceful anteroposterior chest compression (as in squeezing), not by simple falls or CPR. Among the most specific skeletal indicators of inflicted injury in infants.
- Location
- Near the costotransverse junction, posterior rib
- Mechanism
- Forceful anteroposterior chest compression (squeezing)
- Population
- Infants
- Not caused by
- Simple falls or routine CPR
Common questions
Why is this fracture treated as a strong indicator of abuse rather than accident?+
Biomechanical studies have failed to reproduce these fractures with falls, birth trauma, or standard infant CPR, while the compression forces from grasping and squeezing an infant's chest do reproduce the pattern, so its presence carries strong specificity for inflicted injury in the absence of another explanation.
What differentiates it from an anterior or lateral rib fracture in the same infant?+
Location matters because the costotransverse junction is where posterior compressive force concentrates during squeezing; anterior or lateral fractures can arise from a wider range of mechanisms including some accidental ones, so they carry less specific evidentiary weight than posterior fractures.
Related terms
- Abusive Head Trauma (AHT)
- Intracranial injury resulting from violent shaking, with or without impact. Findings include subdural haematoma, subarachnoid haemorrhage, diffuse axonal injury, and retinal haemorrhages....
- Child Advocacy Centre (CAC)
- A child-focused facility that houses the medical, investigative, and support functions of a child abuse case in one location. The multidisciplinary team...
- Metaphyseal Corner Fracture
- A fracture through the metaphyseal collar of a long bone, producing a triangular or bucket-handle fragment. Caused by traction and torsion forces...
- Non-Accidental Injury (NAI)
- Physical harm inflicted deliberately or through gross neglect rather than by accident. The term is preferred over 'child abuse' in clinical documentation...
- Skeletal Survey
- A full radiographic series of the skeleton (AP skull, lateral skull, chest, spine, pelvis, and all long bones) performed in suspected NAI...