The circumstances and characteristics of emergency room-treated injuries in children younger than 1 year of age were studied and unintentional injuries were compared with those caused by abuse. Unintentional injuries were seen 15 times more frequently in an emergency room than injuries caused by abuse. The majority of unintentional injuries were minor, although skull fractures and fractures of the clavicle did occur. In contrast, injuries caused by abuse were commonly multiple and severe and were more likely to result in long-term disability. Results of this study indicate that unintentional injuries are rarely serious and that closed head injury, rib or lower extremity fractures, and abdominal injuries are usually indicative of abuse.
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