Because of decreased bone mineralization (osteopenia) related to prematurity, fractures of the long bones and ribs are not uncommon in premature infants during their initial hospitalization. Usually by the time of hospital discharge, bone mineralization has improved to such an extent that new fractures are uncommon, but there may be evidence of healing fractures on x-ray examination. This fact should be kept in mind if fractures are incidentally noted on an x-ray, to avoid possible misinterpretation as signs of child abuse. Comparison of current x-rays with previous films may help to clarify the issue.
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