Abusive Spiral Fractures of the Humerus: A Videotaped Exception

Fractures of the extremities are the most common skeletal injuries occurring in abused children.^1-4 Young infants are most vulnerable, with 80% of all inflicted skeletal trauma occurring in infants younger than 18 months of age.⁵ In preambulatory infants, spiral diaphyseal fractures of the long bones are considered highly suspicious for inflicted trauma or child abuse.^6,7 Exceptions to this widely held tenet of child abuse should be clearly understood by all.

It is rare for a serious injury event to be captured on videotape. We present summaries of two videotaped cases that demonstrate an identical, unintentional mechanism of midshaft spiral humeral fracture in preambulatory infants. In patient 1, parents of a 5-month-old boy fortuitously videotaped their infant's unintentional right humeral spiral fracture injury as it occurred in their home. In patient 2, the father of a 3-month-old girl sought to explain how he broke his daughter's left humerus