Fracture Dating

10.1055/b-0034-87948

Fracture Dating

Estimation of fracture age should be approached with caution. The current timeline for estimating fracture age ( Table 5.97 ) is based on anecdotal experience of seasoned pediatric radiologists and several small series of children. Although fracture dating is not an inexact science, experienced radiologists should be able to differentiate recent from old fractures separated by weeks or months in time.

**Table 5.97 Fracture dating on conventional radiographs**
Feature	Early	Peak	Delayed
Resolution of soft tissues	2–5 d	4–10 d	10–21 d
Subperiosteal new bone formation	4–10 d	10–14 d	14–21 d
Loss of fracture line definition	10–14 d	14–21 d
Soft callus	10–14 d	14–21 d
Hard callus	14–21 d	21–42 d	42–90 d
Remodeling	3 mo	1 y	2 y to physeal closure
Table 5.97 reproduced with permission from Kleinman PK. Diagnostic imaging of child abuse. 2nd ed. St. Louis: Mosby, 1989.