{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T23:14:30Z","timestamp":1768518870135,"version":"3.49.0"},"reference-count":76,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["Engineering and Physical Sciences Research Council"],"award-info":[{"award-number":["Engineering and Physical Sciences Research Council"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"name":"West Midlands Police","award":["West Midlands Police"],"award-info":[{"award-number":["West Midlands Police"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The estimation of fracture age is important for both clinical and forensic purposes. The objective of this systematic review is to identify the imaging modalities currently used in clinical and forensic practice for fracture ageing, with a view to appraise technologies used, patient demographics studied in research, and the healing stages and criteria defined to estimate time since injury. After conducting a bibliographic literature search, we identified 21 suitable publications for inclusion in the review. Comparison of the literature for fracture ageing found that most research has used 2D radiography, predominantly using an antemortem paediatric population. The remaining publications used MRI, CT, histology, and macroscopy. Although the most frequent number of radiographic stages assessed was six, no two methods assessed the same combination of features. Indeed, variation in the number and definition of healing stages rendered comparison between the publications challenging. Consequently, limited work has been carried out to validate existing methods of ageing. The results therefore reiterate the need for caution in the use of radiographic modalities for forensic fracture ageing. Histology remains the undisputed gold standard, however it is a destructive and exclusively postmortem method. As such, there is need for further research to investigate the potential of additional imaging modalities such as micro-CT, with a high-resolution, 3D, and non-destructive nature. This can serve as a valuable complement to help support and navigate the challenges associated with traditional histopathological methods.<\/jats:p>","DOI":"10.1007\/s00414-025-03589-w","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T04:41:53Z","timestamp":1759725713000},"page":"275-289","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing imaging modalities and healing criteria for the estimation of fracture age: a systematic review"],"prefix":"10.1007","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3264-2061","authenticated-orcid":false,"given":"Charlotte G.","family":"Lawrence","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3802-7914","authenticated-orcid":false,"given":"Mark A.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9648-7607","authenticated-orcid":false,"given":"Charlotte","family":"Primeau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"3589_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/s40134-017-0221-0","author":"TD Roth","year":"2017","unstructured":"Roth TD, Ladd LM, Kempton LB (2017) Fracture healing and imaging evaluation. Curr Radiol Rep. https:\/\/doi.org\/10.1007\/s40134-017-0221-0","journal-title":"Curr Radiol Rep"},{"key":"3589_CR2","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1007\/s00247-020-04945-1","volume":"51","author":"MB Marine","year":"2021","unstructured":"Marine MB, Forbes-Amrhein MM (2021) Fractures of child abuse. Pediatr Radiol 51:1003\u20131013. https:\/\/doi.org\/10.1007\/s00247-020-04945-1","journal-title":"Pediatr Radiol"},{"key":"3589_CR3","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.2214\/ajr.184.4.01841282","volume":"184","author":"I Prosser","year":"2005","unstructured":"Prosser I, Maguire S, Harrison SK, Mann M, Sibert JR, Kemp AM (2005) How old is this fracture? Radiologic dating of fractures in children: a systematic review. Am J Roentgenol 184:1282\u20131286. https:\/\/doi.org\/10.2214\/ajr.184.4.01841282","journal-title":"Am J Roentgenol"},{"key":"3589_CR4","unstructured":"Crown Prosecution Service (2024) Homicide: murder, manslaughter, infanticide and causing or allowing the death or serious injury of a child or vulnerable adult. Crown Prosecution Service. https:\/\/www.cps.gov.uk\/legal-guidance\/homicide-murder-manslaughter-infanticide-and-causing-or-allowing-death-or-serious. Accessed 31 March 2025"},{"key":"3589_CR5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.jflm.2015.04.012","volume":"33","author":"TA Pickett","year":"2015","unstructured":"Pickett TA (2015) The challenges of accurately estimating time of long bone injury in children. J Forensic Leg Med 33:105\u2013110. https:\/\/doi.org\/10.1016\/j.jflm.2015.04.012","journal-title":"J Forensic Leg Med"},{"key":"3589_CR6","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1111\/j.1556-4029.2011.01820.x","volume":"56","author":"CA Malone","year":"2011","unstructured":"Malone CA, Sauer NJ, Fenton TW (2011) A radiographic assessment of pediatric fracture healing and time since injury. J Forensic Sci 56:1123\u20131130. https:\/\/doi.org\/10.1111\/j.1556-4029.2011.01820.x","journal-title":"J Forensic Sci"},{"key":"3589_CR7","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s00247-023-05618-5","volume":"53","author":"M Paddock","year":"2023","unstructured":"Paddock M, Choudhary AK, Jeanes A, Mankad K, Mannes I, Raissaki M, Adamsbaum C, Argyropoulou MI, van Rijn RR, Offiah AC (2023) Controversial aspects of imaging in child abuse: a second roundtable discussion from the ESPR child abuse taskforce. Pediatr Radiol 53:739\u2013751. https:\/\/doi.org\/10.1007\/s00247-023-05618-5","journal-title":"Pediatr Radiol"},{"key":"3589_CR8","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1007\/s00247-020-04648-7","volume":"50","author":"DL Messer","year":"2020","unstructured":"Messer DL, Adler BH, Brink FW, Xiang H, Agnew AM (2020) Radiographic timelines for pediatric fracture healing: a systematic review. Pediatr Radiol 50:1041\u20131048. https:\/\/doi.org\/10.1007\/s00247-020-04648-7","journal-title":"Pediatr Radiol"},{"key":"3589_CR9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.mporth.2009.12.004","volume":"24","author":"PJ Harwood","year":"2010","unstructured":"Harwood PJ, Newman JB, Michael ALR (2010) An update on fracture healing and non-union. Orthop Trauma 24:9\u201323. https:\/\/doi.org\/10.1016\/j.mporth.2009.12.004","journal-title":"Orthop Trauma"},{"key":"3589_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13643-020-01542-z","volume":"10","author":"ML Rethlefsen","year":"2021","unstructured":"Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, Koffel JB, Group PRISMA-S (2021) PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews. Syst Rev 10:1\u201319. https:\/\/doi.org\/10.1186\/s13643-020-01542-z","journal-title":"Syst Rev"},{"key":"3589_CR11","unstructured":"O\u2019Connor JF, Cohen JC (1987) Dating fractures. In: Kleinman PK (ed) Diagnostic imaging of child abuse. Williams & Wilkins, Baltimore, pp 103\u2013113"},{"key":"3589_CR12","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1111\/j.1556-4029.2007.00651.x","volume":"53","author":"LT Barbian","year":"2008","unstructured":"Barbian LT, Sledzik PS (2008) Healing following cranial trauma. J Forensic Sci 53:263\u2013268. https:\/\/doi.org\/10.1111\/j.1556-4029.2007.00651.x","journal-title":"J Forensic Sci"},{"key":"3589_CR13","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.forsciint.2016.01.020","volume":"261","author":"K Baron","year":"2016","unstructured":"Baron K, Neumayer B, Widek T, Schick F, Scheicher S, Hassler E, Scheurer E (2016) Quantitative MR imaging in fracture dating \u2013 initial results. Forensic Sci Int 261:61\u201369. https:\/\/doi.org\/10.1016\/j.forsciint.2016.01.020","journal-title":"Forensic Sci Int"},{"key":"3589_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2019.109909","volume":"302","author":"A Cappella","year":"2019","unstructured":"Cappella A, de Boer HH, Cammilli P, de Angelis D, Messina C, Sconfienza LM, Sardanelli F, Sforza C, Cattaneo C (2019) Histologic and radiological analysis on bone fractures: estimation of posttraumatic survival time in skeletal trauma. Forensic Sci Int 302:109909. https:\/\/doi.org\/10.1016\/j.forsciint.2019.109909","journal-title":"Forensic Sci Int"},{"key":"3589_CR15","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1007\/s00247-021-05038-3","volume":"51","author":"S Crompton","year":"2021","unstructured":"Crompton S, Messina F, Klafkowski G, Hall C, Offiah AC (2021) Validating scoring systems for fracture healing in infants and young children: pilot study. Pediatr Radiol 51:1682\u20131689. https:\/\/doi.org\/10.1007\/s00247-021-05038-3","journal-title":"Pediatr Radiol"},{"key":"3589_CR16","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1002\/oa.2267","volume":"25","author":"HH de Boer","year":"2012","unstructured":"de Boer HH, van der Merwe AE, Hammer S, Steyn M, Maat GJR (2012) Assessing post-traumatic time interval in human dry bone. Int J Osteoarchaeol 25:98\u2013109. https:\/\/doi.org\/10.1002\/oa.2267","journal-title":"Int J Osteoarchaeol"},{"key":"3589_CR17","doi-asserted-by":"publisher","first-page":"2180","DOI":"10.1007\/s00330-016-4569-y","volume":"27","author":"M Fadell","year":"2017","unstructured":"Fadell M, Miller A, Trefan L, Weinman J, Stewart J, Hayes K, Maguire S (2017) Radiological features of healing in newborn clavicular fractures. Eur Radiol 27:2180\u20132187. https:\/\/doi.org\/10.1007\/s00330-016-4569-y","journal-title":"Eur Radiol"},{"key":"3589_CR18","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1016\/j.crad.2011.06.001","volume":"66","author":"KE Halliday","year":"2011","unstructured":"Halliday KE, Broderick NJ, Somers JM, Hawkes R (2011) Dating fractures in infants. Clin Radiol 66:1049\u20131054. https:\/\/doi.org\/10.1016\/j.crad.2011.06.001","journal-title":"Clin Radiol"},{"key":"3589_CR19","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s10140-016-1462-6","volume":"24","author":"T Hosokawa","year":"2017","unstructured":"Hosokawa T, Yamada Y, Sato Y, Tanami Y, Oguma E (2017) Subperiosteal new bone and callus formations in neonates with femoral shaft fracture at birth. Emerg Radiol 24:143\u2013148. https:\/\/doi.org\/10.1007\/s10140-016-1462-6","journal-title":"Emerg Radiol"},{"key":"3589_CR20","doi-asserted-by":"publisher","first-page":"75","DOI":"10.2214\/ajr.175.1.1750075","volume":"175","author":"O Islam","year":"2000","unstructured":"Islam O, Soboleski D, Symons S, Davidson LK, Ashworth MA, Babyn P (2000) Development and duration of radiographic signs of bone healing in children. Am J Roentgenol 175:75\u201378. https:\/\/doi.org\/10.2214\/ajr.175.1.1750075","journal-title":"Am J Roentgenol"},{"key":"3589_CR21","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.37506\/IJFMT.V14I3.10511","volume":"14","author":"AS Mahmoud","year":"2020","unstructured":"Mahmoud AS, Fahmy AM, Mahmoud AM, Bayomi AA, El-Amir AY (2020) Dating of long bone fracture healing among Egyptian pediatrics by radiology (x-ray). Indian J Forensic Med Toxicol 14:1048\u20131052. https:\/\/doi.org\/10.37506\/IJFMT.V14I3.10511","journal-title":"Indian J Forensic Med Toxicol"},{"key":"3589_CR22","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1097\/PAF.0000000000000914","volume":"45","author":"S Moirangthem","year":"2024","unstructured":"Moirangthem S, Arora A, Vidua RK, Goel G (2024) Autopsy-based comparative study of gross and histopathological findings at bone fracture surfaces before and after death. Am J Forensic Med Pathol 45:111\u2013117. https:\/\/doi.org\/10.1097\/PAF.0000000000000914","journal-title":"Am J Forensic Med Pathol"},{"key":"3589_CR23","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/his.13850","volume":"75","author":"A Naqvi","year":"2019","unstructured":"Naqvi A, Raynor E, Freemont AJ (2019) Histological ageing of fractures in infants: a practical algorithm for assessing infants suspected of accidental or non-accidental injury. Histopathology 75:74\u201380. https:\/\/doi.org\/10.1111\/his.13850","journal-title":"Histopathology"},{"key":"3589_CR24","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.2214\/AJR.11.6734","volume":"198","author":"I Prosser","year":"2012","unstructured":"Prosser I, Lawson Z, Evans A, Harrison S, Morris S, Maguire S, Kemp AM (2012) A timetable for the radiologic features of fracture healing in young children. Am J Roentgenol 198:1014\u20131020. https:\/\/doi.org\/10.2214\/AJR.11.6734","journal-title":"Am J Roentgenol"},{"key":"3589_CR25","doi-asserted-by":"publisher","first-page":"e467","DOI":"10.1016\/j.crad.2013.03.017","volume":"68","author":"TR Sanchez","year":"2013","unstructured":"Sanchez TR, Nguyen H, Palacios W, Doherty M, Coulter K (2013) Retrospective evaluation and dating of non-accidental rib fractures in infants. Clin Radiol 68:e467\u2013e471. https:\/\/doi.org\/10.1016\/j.crad.2013.03.017","journal-title":"Clin Radiol"},{"key":"3589_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2021.111058","volume":"329","author":"A Viero","year":"2021","unstructured":"Viero A, Obertov\u00e1 Z, Cappella A, Messina C, Sconfienza LM, Sardanelli F, Tritella S, Montisci M, Gregori D, Tagliaro F, Cattaneo C (2021) The problem of dating fractures: a retrospective observational study of radiologic features of fracture healing in adults. Forensic Sci Int 329:111058. https:\/\/doi.org\/10.1016\/j.forsciint.2021.111058","journal-title":"Forensic Sci Int"},{"key":"3589_CR27","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1007\/s00247-014-2995-z","volume":"44","author":"MM Walters","year":"2014","unstructured":"Walters MM, Forbes PW, Buonomo C, Kleinman PK (2014) Healing patterns of clavicular birth injuries as a guide to fracture dating in cases of possible infant abuse. Pediatr Radiol 44:1224\u20131229. https:\/\/doi.org\/10.1007\/s00247-014-2995-z","journal-title":"Pediatr Radiol"},{"key":"3589_CR28","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s00256-016-2563-8","volume":"46","author":"C Warner","year":"2017","unstructured":"Warner C, Maguire S, Trefan L, Miller A, Weinman J, Fadell M (2017) A study of radiological features of healing in long bone fractures among infants less than a year. Skeletal Radiol 46:333\u2013341. https:\/\/doi.org\/10.1007\/s00256-016-2563-8","journal-title":"Skeletal Radiol"},{"key":"3589_CR29","first-page":"16","volume":"45","author":"LI Yeo","year":"1994","unstructured":"Yeo LI, Reed MH (1994) Staging of healing of femoral fractures in children. Can Assoc Radiol J 45:16\u201319","journal-title":"Can Assoc Radiol J"},{"key":"3589_CR30","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1017\/CBO9780511862366.014","volume-title":"Diagnostic imaging of child abuse","author":"PK Kleinman","year":"2015","unstructured":"Kleinman PK, Walters MM (2015) Dating fractures. In: Kleinman PK (ed) Diagnostic imaging of child abuse, 3rd edn. Cambridge Univ, Cambridge, pp 208\u2013216","edition":"3"},{"key":"3589_CR31","doi-asserted-by":"publisher","first-page":"10543","DOI":"10.1038\/s41598-022-14530-1","volume":"12","author":"A Viero","year":"2022","unstructured":"Viero A, Biehler-Gomez L, Messina C, Cappella A, Giannoukos K, Viel G, Tagliaro F, Cattaneo C (2022) Utility of micro-CT for dating post-cranial fractures of known post-traumatic ages through 3D measurements of the trabecular inner morphology. Sci Rep 12:10543. https:\/\/doi.org\/10.1038\/s41598-022-14530-1","journal-title":"Sci Rep"},{"key":"3589_CR32","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1097\/TA.0b013e3181a7c16d","volume":"68","author":"D Whelan","year":"2010","unstructured":"Whelan D, Bhandari M, Stephen D, Kreder H, McKee M, Zdero R, Schemitsch EH (2010) Development of the radiographic union score for tibial fractures for the assessment of tibial fracture healing after intramedullary fixation. J Trauma 68:629\u2013632. https:\/\/doi.org\/10.1097\/TA.0b013e3181a7c16d","journal-title":"J Trauma"},{"key":"3589_CR33","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.mporth.2015.05.002","volume":"30","author":"D Ferguson","year":"2016","unstructured":"Ferguson D, Scott B (2016) The enigmatic role and development of the clavicle. Orthop Trauma 30:273\u2013276. https:\/\/doi.org\/10.1016\/j.mporth.2015.05.002","journal-title":"Orthop Trauma"},{"key":"3589_CR34","doi-asserted-by":"publisher","first-page":"460","DOI":"10.14744\/nci.2020.82713","volume":"7","author":"U Aygun","year":"2020","unstructured":"Aygun U (2020) The feature assessment of the bone fractures in 1020 children and review of the literature. North Clin Istanb 7:460\u2013466. https:\/\/doi.org\/10.14744\/nci.2020.82713","journal-title":"North Clin Istanb"},{"key":"3589_CR35","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.mpsur.2024.12.001","volume":"43","author":"Q Mustafa","year":"2025","unstructured":"Mustafa Q, Wilson C, Crook T (2025) Distal radius fractures, current evidence including DRAFFT trial. Surg (Oxf) 43:96\u2013101. https:\/\/doi.org\/10.1016\/j.mpsur.2024.12.001","journal-title":"Surg (Oxf)"},{"key":"3589_CR36","doi-asserted-by":"publisher","first-page":"e42","DOI":"10.2106\/JBJS.L.00369","volume":"95","author":"P-H Randsborg","year":"2013","unstructured":"Randsborg P-H, Gulbrandsen P, Benth JS, Sivertsen EA, Hammer O-L, Fuglesang HFS, Ar\u00f8en A (2013) Fractures in children: epidemiology and activity-specific fracture rates. J Bone Joint Surg Am 95:e42. https:\/\/doi.org\/10.2106\/JBJS.L.00369","journal-title":"J Bone Joint Surg Am"},{"key":"3589_CR37","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.paed.2016.10.003","volume":"27","author":"IM Prosser","year":"2017","unstructured":"Prosser IM, Harrison SK (2017) Interpreting fractures in child maltreatment. Paediatr Child Health 27:28\u201332. https:\/\/doi.org\/10.1016\/j.paed.2016.10.003","journal-title":"Paediatr Child Health"},{"key":"3589_CR38","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jflm.2018.09.002","volume":"60","author":"E Raynor","year":"2018","unstructured":"Raynor E, Konala P, Freemont A (2018) The detection of significant fractures in suspected infant abuse. J Forensic Leg Med 60:9\u201314. https:\/\/doi.org\/10.1016\/j.jflm.2018.09.002","journal-title":"J Forensic Leg Med"},{"key":"3589_CR39","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.forsciint.2019.01.027","volume":"297","author":"W Baier","year":"2019","unstructured":"Baier W, Mangham C, Warnett JM, Payne M, Painter M, Williams MA (2019) Using histology to evaluate micro-CT findings of trauma in three post-mortem samples \u2013 first steps towards method validation. Forensic Sci Int 297:27\u201334. https:\/\/doi.org\/10.1016\/j.forsciint.2019.01.027","journal-title":"Forensic Sci Int"},{"key":"3589_CR40","doi-asserted-by":"crossref","unstructured":"Aksoy U, \u00d6zkayalar H, Orhan K (2020) Micro-CT in comparison with histology in the qualitative assessment of bone and pathologies. In: Orhan K (ed) Micro-computed tomography (micro-CT) in medicine and engineering. Springer Nature, Cham, pp 109\u2013124","DOI":"10.1007\/978-3-030-16641-0_8"},{"key":"3589_CR41","doi-asserted-by":"publisher","first-page":"S29","DOI":"10.1016\/j.injury.2020.08.016","volume":"5","author":"JA Nicholson","year":"2021","unstructured":"Nicholson JA, Yapp LZ, Keating JF, Simpson AHRW (2021) Monitoring of fracture healing. Update on current and future imaging modalities to predict union. Injury 5:S29\u2013S34. https:\/\/doi.org\/10.1016\/j.injury.2020.08.016","journal-title":"Injury"},{"key":"3589_CR42","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.2214\/AJR.12.8767","volume":"199","author":"S Ross","year":"2012","unstructured":"Ross S, Ebner L, Flach P, Brodhage R, Bolliger SA, Christe A, Thali MJ (2012) Postmortem whole-body MRI in traumatic causes of death. Am J Roentgenol 199:1186\u20131192. https:\/\/doi.org\/10.2214\/AJR.12.8767","journal-title":"Am J Roentgenol"},{"key":"3589_CR43","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.jflm.2017.11.004","volume":"53","author":"A Drury","year":"2018","unstructured":"Drury A, Cunningham C (2018) Determining when a fracture occurred: does the method matter? Analysis of the similarity of three different methods for estimating time since fracture of juvenile long bones. J Forensic Leg Med 53:97\u2013105. https:\/\/doi.org\/10.1016\/j.jflm.2017.11.004","journal-title":"J Forensic Leg Med"},{"key":"3589_CR44","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s00256-018-3051-0","volume":"48","author":"JS Fischer","year":"2019","unstructured":"Fischer JS, Kazam JJ, Fufa D, Bartolotta RJ (2019) Radiologic evaluation of fracture healing. Skeletal Radiol 48:349\u2013361. https:\/\/doi.org\/10.1007\/s00256-018-3051-0","journal-title":"Skeletal Radiol"},{"key":"3589_CR45","volume-title":"Radiological atlas of child abuse","author":"AC Offiah","year":"2009","unstructured":"Offiah AC, Hall CM (2009) Radiological atlas of child abuse. CRC, Boca Raton"},{"key":"3589_CR46","first-page":"30","volume":"30","author":"WA Cumming","year":"1979","unstructured":"Cumming WA (1979) Neonatal skeletal fractures. Birth trauma or child abuse? J Can Assoc Radiol 30:30\u201333","journal-title":"J Can Assoc Radiol"},{"key":"3589_CR47","unstructured":"Hufnagl KB (2005) An investigation of time since injury: a radiographic study of fracture healing. Dissertation, Louisiana State University"},{"key":"3589_CR48","first-page":"161","volume-title":"Textbook of veterinary diagnostic radiology","author":"RL Toal","year":"2002","unstructured":"Toal RL, Mitchell SK (2002) Fracture healing and complications. In: Thrall DE (ed) Textbook of veterinary diagnostic radiology, 4th edn. WB Saunders Company, Pennsylvania, pp 161\u2013178","edition":"4"},{"key":"3589_CR49","first-page":"203","volume-title":"Radiology of skeletal trauma","author":"RW Hendrix","year":"2002","unstructured":"Hendrix RW (2002) Fracture healing. In: Rogers LF (ed) Radiology of skeletal trauma, 3rd edn. Churchill Livingstone, Philadelphia, pp 203\u2013230","edition":"3"},{"key":"3589_CR50","doi-asserted-by":"publisher","first-page":"2112","DOI":"10.1111\/1556-4029.14541","volume":"65","author":"S Tritella","year":"2020","unstructured":"Tritella S, Obertov\u00e1 Z, Sconfienza LM, Collini F, Cristini E, Amadasi A, Ciprandi B, Spairani R, Albano D, Viero A, Cappella A, Cammilli P, Sardanelli F, Cattaneo C (2020) Multi-rater agreement using the adapted fracture healing scale (AFHS) for the assessment of tubular bones on conventional radiographs: preliminary study. J Forensic Sci 65:2112\u20132116. https:\/\/doi.org\/10.1111\/1556-4029.14541","journal-title":"J Forensic Sci"},{"key":"3589_CR51","doi-asserted-by":"crossref","unstructured":"Rao AG, Hill JG (2014) Non-central nervous system imaging of pediatric inflicted injury. In: Collins KA, Byard RW (eds) Forensic pathology of infancy and childhood. Springer, New York, pp 539\u2013584","DOI":"10.1007\/978-1-61779-403-2_24"},{"key":"3589_CR52","doi-asserted-by":"publisher","DOI":"10.1002\/wfs2.1389","author":"JM Fleischman","year":"2020","unstructured":"Fleischman JM, Soto Martinez ME, Wiersema JM, Pinto DC (2020) The role of the forensic anthropologist in the pediatric autopsy: interpretations, contributions, and challenges. WIREs Forensic Sci. https:\/\/doi.org\/10.1002\/wfs2.1389","journal-title":"WIREs Forensic Sci"},{"key":"3589_CR53","doi-asserted-by":"publisher","first-page":"704","DOI":"10.3109\/17453678809149430","volume":"59","author":"SV Skak","year":"1988","unstructured":"Skak SV, Jensen TT (1988) Femoral shaft fracture in 265 children: log-normal correlation with age of speed of healing. Acta Orthop Scand 59:704\u2013707. https:\/\/doi.org\/10.3109\/17453678809149430","journal-title":"Acta Orthop Scand"},{"key":"3589_CR54","unstructured":"Royal College of Paediatrics and Child Health (2020) Child Protection Evidence \u2013 Systematic review on Fractures. Royal College of Paediatrics and Child Health. https:\/\/childprotection.rcpch.ac.uk\/child-protection-evidence\/fractures-systematic-review\/ Accessed 3 March 2025"},{"key":"3589_CR55","unstructured":"The Society and College of Radiographers and The Royal College of Radiologists (2018) The Radiological Investigation of Suspected Physical Abuse in Children. The Society of Radiographers. https:\/\/www.sor.org\/learning-advice\/professional-body-guidance-and-publications\/documents-and-publications\/archive-documents\/the-radiological-investigation-of-physical-abuse-i#:~:text=It%20revamps%20initial%20guidance%20from%202008%20and%20incorporates,This%20document%20is%20available%20as%20a%20PDF%20only. Accessed 3 March 2025"},{"key":"3589_CR56","doi-asserted-by":"publisher","first-page":"1868","DOI":"10.1007\/s00330-024-11052-4","volume":"35","author":"GC Colleran","year":"2025","unstructured":"Colleran GC, Fossmark M, Rosendahl K, Argyropoulou M, Mankad K, Offiah AC (2025) ESR essentials: imaging of suspected child abuse \u2013 practice recommendations by the European society of paediatric radiology. Eur Radiol 35:1868\u20131880. https:\/\/doi.org\/10.1007\/s00330-024-11052-4","journal-title":"Eur Radiol"},{"key":"3589_CR57","doi-asserted-by":"crossref","unstructured":"Boyd D (2018) The anatomical basis for fracture repair: recognition of the healing continuum and its forensic applications to investigations of pediatric and elderly abuse. In: Boyd CC Jr., Boyd D (eds) Forensic anthropology: theoretical framework and scientific basis. Wiley, Chichester, pp 149\u2013200","DOI":"10.1002\/9781119226529.ch9"},{"key":"3589_CR58","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.3390\/math9243227","volume":"9","author":"F Hr\u017ei\u0107","year":"2021","unstructured":"Hr\u017ei\u0107 F, Janisch M, \u0160tajduhar I, Lerga J, Sorantin E, Tschauner S (2021) Modeling uncertainty in fracture age estimation from pediatric wrist radiographs. Mathematics 9:3227. https:\/\/doi.org\/10.3390\/math9243227","journal-title":"Mathematics"},{"key":"3589_CR59","doi-asserted-by":"publisher","first-page":"749","DOI":"10.3390\/biology11050749","volume":"11","author":"KM Kyllonen","year":"2022","unstructured":"Kyllonen KM, Monson KL, Smith MA (2022) Postmortem and antemortem forensic assessment of pediatric fracture healing from radiographs and machine learning classification. Biology 11:749. https:\/\/doi.org\/10.3390\/biology11050749","journal-title":"Biology"},{"key":"3589_CR60","doi-asserted-by":"publisher","first-page":"2206","DOI":"10.1007\/s00247-022-05380-0","volume":"52","author":"A Tsai","year":"2022","unstructured":"Tsai A, Grant PE, Warfield SK, Ou Y, Kleinman PK (2022) Deep learning of birth-related infant clavicle fractures: a potential virtual consultant for fracture dating. Pediatr Radiol 52:2206\u20132214. https:\/\/doi.org\/10.1007\/s00247-022-05380-0","journal-title":"Pediatr Radiol"},{"key":"3589_CR61","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s12024-016-9821-x","volume":"13","author":"OJ Arthurs","year":"2017","unstructured":"Arthurs OJ, Hutchinson JC, Sebire NJ (2017) Current issues in postmortem imaging of perinatal and childhood deaths. Forensic Sci Med Pathol 13:58\u201366. https:\/\/doi.org\/10.1007\/s12024-016-9821-x","journal-title":"Forensic Sci Med Pathol"},{"key":"3589_CR62","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2021.110789","volume":"325","author":"W Baier","year":"2021","unstructured":"Baier W, Norman DG, Williams MA (2021) Micro-CT for the examination of paediatric rib injuries: a case series. Forensic Sci Int 325:110789. https:\/\/doi.org\/10.1016\/j.forsciint.2021.110789","journal-title":"Forensic Sci Int"},{"key":"3589_CR63","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1007\/s00414-021-02582-3","volume":"135","author":"A Viero","year":"2021","unstructured":"Viero A, Biehler-Gomez L, Cappella A, Messina C, Montisci M, Cattaneo C (2021) The potential of micro-CT for dating post-cranial bone fractures: a macroscopic, radiographic, and microtomography study of fractures of known post-traumatic ages. Int J Legal Med 135:1913\u20131921. https:\/\/doi.org\/10.1007\/s00414-021-02582-3","journal-title":"Int J Legal Med"},{"key":"3589_CR64","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s40336-022-00510-y","volume":"10","author":"G Franchetti","year":"2022","unstructured":"Franchetti G, Viel G, Fais P, Fichera G, Cecchin D, Cecchetto G, Giraudo C (2022) Forensic applications of micro-computed tomography: a systematic review. Clin Transl Imaging 10:597\u2013610. https:\/\/doi.org\/10.1007\/s40336-022-00510-y","journal-title":"Clin Transl Imaging"},{"key":"3589_CR65","doi-asserted-by":"publisher","DOI":"10.1016\/j.legalmed.2021.101914","volume":"52","author":"N Akbulut","year":"2021","unstructured":"Akbulut N, \u00c7etin S, Bileceno\u011flu B, Altan A, Ocak M, \u015een E, Atakan C, Orhan K (2021) Evaluation of the detectability of early mandible fracture healing findings in terms of vitality aspect by using micro-CT technology in postmortem interval. Leg Med 52:101914. https:\/\/doi.org\/10.1016\/j.legalmed.2021.101914","journal-title":"Leg Med"},{"key":"3589_CR66","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1111\/1556-4029.15007","volume":"67","author":"K Alsop","year":"2022","unstructured":"Alsop K, Norman DG, Baier W, Colclough J, Williams MA (2022) Advantages of micro-CT in the case of a complex dismemberment. J Forensic Sci 67:1258\u20131266. https:\/\/doi.org\/10.1111\/1556-4029.15007","journal-title":"J Forensic Sci"},{"key":"3589_CR67","doi-asserted-by":"publisher","first-page":"5561","DOI":"10.1007\/s00330-024-10679-7","volume":"34","author":"SC Shelmerdine","year":"2024","unstructured":"Shelmerdine SC, Davendralingam N, Langan D, Palm L, Mangham C, Arthurs OJ, CORNRD Study Collaborators (2024) Post-mortem skeletal survey (PMSS) versus post-mortem computed tomography (PMCT) for the detection of corner metaphyseal lesions (CML) in children. Eur Radiol 34:5561\u20135569. https:\/\/doi.org\/10.1007\/s00330-024-10679-7","journal-title":"Eur Radiol"},{"key":"3589_CR68","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.scijus.2024.04.001","volume":"64","author":"C Primeau","year":"2024","unstructured":"Primeau C, Norman DG, Baier W, Goia S, Blaik S, Williams MA (2024) Micro-CT in a forensic examination of a fatal child abuse case: a case report. Sci Justice 64:297\u2013304. https:\/\/doi.org\/10.1016\/j.scijus.2024.04.001","journal-title":"Sci Justice"},{"key":"3589_CR69","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.forsciint.2012.10.030","volume":"225","author":"GN Rutty","year":"2013","unstructured":"Rutty GN, Brough A, Biggs MJP, Robinson C, Lawes SDA, Hainsworth SV (2013) The role of micro-computed tomography in forensic investigations. Forensic Sci Int 225:60\u201366. https:\/\/doi.org\/10.1016\/j.forsciint.2012.10.030","journal-title":"Forensic Sci Int"},{"key":"3589_CR70","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/j.crad.2023.06.001","volume":"78","author":"H Edwards","year":"2023","unstructured":"Edwards H, Shelmerdine SC, Arthurs OJ (2023) Forensic post-mortem CT in children. Clin Radiol 78:839\u2013847. https:\/\/doi.org\/10.1016\/j.crad.2023.06.001","journal-title":"Clin Radiol"},{"key":"3589_CR71","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.forsciint.2018.10.027","volume":"293","author":"DG Norman","year":"2018","unstructured":"Norman DG, Baier W, Watson DG, Burnett B, Painter M, Williams MA (2018) Micro-CT for saw mark analysis on human bone. Forensic Sci Int 293:91\u2013100. https:\/\/doi.org\/10.1016\/j.forsciint.2018.10.027","journal-title":"Forensic Sci Int"},{"key":"3589_CR72","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1007\/s12194-015-0334-1","volume":"9","author":"N Miyahara","year":"2016","unstructured":"Miyahara N, Kokubo T, Hara Y, Yamada A, Koike T, Arai Y (2016) Evaluation of X-ray doses and their corresponding biological effects on experimental animals in cone-beam micro-CT scans (R-mCT2). Radiol Phys Technol 9:60\u201368. https:\/\/doi.org\/10.1007\/s12194-015-0334-1","journal-title":"Radiol Phys Technol"},{"key":"3589_CR73","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1146\/annurev-bioeng-071910-124717","volume":"13","author":"E Ritman","year":"2011","unstructured":"Ritman E (2011) Current status of developments and applications of micro-CT. Annu Rev Biomed Eng 13:531\u2013552. https:\/\/doi.org\/10.1146\/annurev-bioeng-071910-124717","journal-title":"Annu Rev Biomed Eng"},{"key":"3589_CR74","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.bone.2008.10.039","volume":"44","author":"EF Morgan","year":"2009","unstructured":"Morgan EF, Mason ZD, Chien KB, Pfeiffer AJ, Barnes GL, Einhorn TA, Gerstenfeld LC (2009) Micro-computed tomography assessment of fracture healing: relationships among callus structure, composition, and mechanical function. Bone 44:335\u2013344. https:\/\/doi.org\/10.1016\/j.bone.2008.10.039","journal-title":"Bone"},{"key":"3589_CR75","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1016\/j.forsciint.2014.08.021","volume":"244","author":"M Steyn","year":"2014","unstructured":"Steyn M, de Boer HH, Van der Merwe AE (2014) Cranial trauma and the assessment of posttraumatic survival time. Forensic Sci Int 244:e25\u2013e29. https:\/\/doi.org\/10.1016\/j.forsciint.2014.08.021","journal-title":"Forensic Sci Int"},{"key":"3589_CR76","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1007\/s00247-013-2813-z","volume":"44","author":"A Tsai","year":"2014","unstructured":"Tsai A, McDonald AG, Rosenberg AE, Gupta R, Kleinman PK (2014) High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse. Pediatr Radiol 44:124\u2013140. https:\/\/doi.org\/10.1007\/s00247-013-2813-z","journal-title":"Pediatr Radiol"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-025-03589-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-025-03589-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-025-03589-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:10:53Z","timestamp":1768464653000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00414-025-03589-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":76,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["3589"],"URL":"https:\/\/doi.org\/10.1007\/s00414-025-03589-w","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"value":"0937-9827","type":"print"},{"value":"1437-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,6]]},"assertion":[{"value":"9 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"N\/A.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"N\/A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure of potential conflicts of interest"}},{"value":"N\/A.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}}]}}