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Abuse was identified in 48% of children less than 18months with humeral fractures. Among those with femoral fractures, abuse was diagnosed in 34% and 25% of children aged less than 12 and 18months, respectively. Among children who were not in an independently verified incident, the authors strongly recommend routine evaluation for child abuse, including specialty child abuse consultation, for 1) children aged less than 3years old presenting with rib fractures and 2) children aged less than 18months presenting with humeral or femoral frac
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