Investigating rolling as mechanism for humeral fractures in non-ambulant infants: a preliminary finite element study. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Altai, Z.; Viceconti, M.; Li, X.; Offiah, A.C.
• Is Part Of: Clinical radiology. Volume 75:Issue 1(2020)
• Page Start: 78.e9
• Page End: 78.e16
• Publication Date: 2020-01
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2019.08.026
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To use personalised computed tomography (CT)-based finite element models to quantitatively investigate the likelihood of self-inflicted humeral fracture in non-ambulant infants secondary to rolling. MATERIALS AND METHODS: Three whole-body post-mortem CT examinations of children at the age of rolling (two 4-month-old and one 6-month-old) were used. The mechanical moment needed by each infant to perform a rolling manoeuvre was calculated and applied to the finite element model in order to simulate spontaneous rolling from the prone to the supine position. RESULTS: The maximum predicted strains were found to be substantially lower (with a difference of >80%) than the elastic limit of the bone. CONCLUSION: Results of this study challenge the plausibility of self-inflicted humeral fracture caused by rolling in non-ambulant infants and indicate that it is unlikely for a humeral fracture to result from this mechanism without the assistance of an external force. Highlights: Humeral fractures are unlikely to occur in non-ambulant infants through rolling without external intervention. An additional relativity small external force is required to fracture the humerus. Inflicted injury should be considered as differential diagnosis if such a history is given by the carer(s).