Recognition of skeletal fractures in infants: An autopsy technique

Jennifer C. Love, Luis A. Sanchez

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Complete recognition and documentation of injury pattern is crucial in the diagnosis of child abuse. Skeletal fractures regarded as highly specific to nonaccidental injury in infants include posterior rib, scapular, metaphyseal, and spinous process fractures. These injuries are often occult, especially when acute, to standard radiologic and autopsy procedures. The presented autopsy technique requires incising and reflecting skeletal muscles to expose the bones and costal osseous joints in situ, increasing the opportunity to recognize skeletal injury. Fractured or atypical appearing bones are removed and processed for complete evaluation. The bones are processed by macerating the soft tissue in a water soap bath at an elevated temperature. To aid in reconstruction of the decedent, long bones are replaced with wooden dowels and the chest cavity is packed with the organ bag. The technique is invasive and recommended for cases in which the pathologist has reasonable suspicion of acute or remote trauma.

Original languageEnglish (US)
Pages (from-to)1443-1446
Number of pages4
JournalJournal of Forensic Sciences
Issue number6
StatePublished - Nov 2009


  • Autopsy techniques
  • Classic metaphyseal lesions
  • Forensic anthropology
  • Forensic pathology
  • Forensic science
  • Skeletal injury

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Genetics


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