• Loss of fracture line definition — 10 to 21 days.
• Remodeling — 3 months to 2 years. For further information, see ref. 31.
Detecting occult injury is particularly important in the younger child and infant and recommended indications for a skeletal survey include the following (17,25,28,32):
• Any child younger than 2 years when there is a suspicion of physical abuse.
• Any child younger than 2 years presenting with a fracture suggestive of abuse.
• Consider in children aged 2-4 years with severe bruising.
• Older children with severe injuries.
• Children dying in unusual or suspicious circumstances.
• Physical abuse in an infant twin (or multiple birth sets) younger than 1 year— consider skeletal survey of the other infant(s) (33).
• Repeat views, particularly of ribs, may be useful 2 weeks after the initial survey, because periosteal reaction may not have formed around acute injuries.
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