Children in general are at greater risk because of their high activity levels. Children that have risk-prone behaviors are at even greater risk.

Over 2.5 million child abuse and neglect cases are reported every year, and thirty-five out of every hundred cases are physical abuse cases. Bone fractures are sometimes part of the physical abuse of children; knowing the symptoms of bone fractures in physical abuse and recognizing the actual risks in physical abuse will help forward the prevention of future abuse and injuries. Astoundingly, these abuse fractures, if not dealt with correctly, have a potential to lead to the death of the child.

Fracture patterns in abuse fractures that are very common with abuse are fractures in the growing part of a long bone (between the shaft and the separated part of the bone), fractures of the humeral shaft (long bone between the shoulder and elbow), ribs, scapula, outer end of the clavicle, and vertebra. Multiple fractures of varying age, bilateral fractures, and complex skull fractures are also linked to abuse. Fractures of varying ages occur in about thirteen percent of all cases.

Supracondylar humerus fractures account for 55%-75% of all elbow fractures. They most commonly occur in children between ages 5–8, because remodeling of bone in this age group causes a decreased supracondylar anteroposterior diameter.

In general, SCFE is caused by increased force applied across the epiphysis, or a decrease in the resistance within the physis to shearing. No single cause accounts for SCFEs, as several factors play a role in the development of a SCFE, particularly mechanical and endocrine (hormone-related) factors. Mechanical risk factors include obesity, coxa profunda, femoral or acetabular retroversion. Obesity is the most significant risk factor. In 65 percent of cases of SCFE, the person is over the 95th percentile for weight. Common misconception is heredity. Majority of cause is due to being overweight. Endocrine diseases also contribute, such as hypothyroidism, hypopituitarism, and renal osteodystrophy.

Distal radius fractures are the most common fractures seen in adults, with incidence in females outnumbering incidence in males by a factor of 2-3. Men who sustain distal radius fractures are usually younger, generally in their fifth decade (vs. seventh decade in females). The elderly are more susceptible because of the osteopenia and osteoporosis commonly seen in this age group. The majority of these fractures are extra-articular (i.e. not involving the joint).

This is also a common injury in children which may involve the growth plate (Salter-Harris fracture).

In young adults, the injury is often severe as a greater force is necessary to produce the injury.

Removable splints result in better outcomes than casting in children with torus fractures of the distal radius.

The greenstick fracture pattern occurs as a result of bending forces. Activities with a high risk of falling are risk factors. Non-accidental injury more commonly causes spiral (twisting) fractures but a blow on the forearm or shin could cause a green stick fracture. The fracture usually occurs in children and teens because their bones are flexible, unlike adults whose more brittle bones usually break.

In children the outcome of distal radius fracture treatment in casts is usually very successful with healing and return to normal function expected. Some residual deformity is common but this often remodels as the child grows. In the elderly, distal radius fractures heal and may result in adequate function following non-operative treatment. A large proportion of these fractures occur in elderly people that may have less requirement for strenuous use of their wrists. Some of these patients tolerate severe deformities and minor loss of wrist motion very well even without reduction of the fracture. In this low demand group only a short period of immobilization is indicated as rapid mobilization improves functional outcome.

In younger patients the injury requires greater force and results in more displacement particularly to the articular surface. Unless an accurate reduction of the joint surface is obtained, these patients are very likely to have long term symptoms of pain, arthritis, and stiffness.

Colles fractures occur in all age groups, although certain patterns follow an age distribution.

- In the elderly, because of the weaker cortex, the fracture is more often extra-articular.

- Younger individuals tend to require a higher energy force to cause the fracture and tend to have more complex intra-articular fractures. In children with open epiphyses, an equivalent fracture is the "epiphyseal slip", as can be seen in other joints, such as a slipped capital femoral epiphysis in the hip. This is a Salter I or II fracture with the deforming forces directed through the weaker epiphyseal plate.

- More common in women because of post-menopausal osteoporosis.

Femoral shaft fractures occur in a bimodal distribution, whereby they are most commonly seen in males age 15-24 (due to high energy trauma) and females aged 75 or older (pathologic fractures due to osteoporosis, low-energy falls).

The etiology of the Galeazzi fracture is thought to be a fall that causes an axial load to be placed on a hyperpronated forearm. However, researchers have been unable to reproduce the mechanism of injury in a laboratory setting.

After the injury, the fracture is subject to deforming forces including those of the brachioradialis, pronator quadratus, and thumb extensors, as well as the weight of the hand. The deforming muscular and soft-tissue injuries that are associated with this fracture cannot be controlled with plaster immobilization.

In most cases, patients are discharged from an emergency department with pain medicine and a cast or sling. These fractures are typically minor and heal naturally over the course of a few weeks. Fractures of the proximal region, especially among elderly patients, may limit future shoulder activity. Severe fractures are usually resolved with surgical intervention, followed by a period of healing using a cast or sling. Severe fractures often cause long-term loss of physical ability. Complications in the recovery process of severe fractures include osteonecrosis, malunion or nonunion of the fracture, stiffness, and rotator cuff dysfunction, which require additional intervention in order for the patient to fully recover.

SCFE affects approximately 1-10 per 100,000 children. The incidence varies by geographic location, season of the year, and ethnicity. In eastern Japan, the incidence is 0.2 per 100,000 and in the northeastern U.S. it is about 10 per 100,000. Africans and Polynesians have higher rates of SCFE.

SCFEs are most common in adolescents 11–15 years of age, and affects boys more frequently than girls (male 2:1 female). It is strongly linked to obesity, and weight loss may decrease the risk. Other risk factors include: family history, endocrine disorders, radiation / chemotherapy, and mild trauma.

The left hip is more often affected than the right. Over half of cases may have involvement on both sides (bilateral).

Humerus fractures are among the most common of fractures. Proximal fractures make up 5% of all fractures and 25% of humerus fractures, middle fractures about 60% of humerus fractures (12% of all fractures), and distal fractures the remainder. Among proximal fractures, 80% are one-part, 10% are two-part, and the remaining 10% are three- and four-part. The most common location of proximal fractures is at the surgical neck of the humerus. Incidence of proximal fractures increases with age, with about 75% of cases occurring among people over the age of 60. In this age group, about three times as many women than men experience a proximal fracture. Middle fractures are also common among the elderly, but they frequently occur among physically active young adult men who experience physical trauma to the humerus. Distal fractures are rare among adults, occurring primarily in children who experience physical trauma to the elbow region.

It occurs in older children at the end of growth. Variability in fracture pattern is due to progression of physeal closure as anterolateral part of distal tibial physis is the last to close. When the lateral physis is the only portion not fused, external rotation may lead to Tillaux or Triplane fractures.

In children, whose bones are still developing, there are risks of either a growth plate injury or a greenstick fracture.

- A greenstick fracture occurs due to mechanical failure on the tension side. That is, since the bone is not so brittle as it would be in an adult, it does not completely fracture, but rather exhibits bowing without complete disruption of the bone's cortex in the surface opposite the applied force.

- Growth plate injuries, as in Salter-Harris fractures, require careful treatment and accurate reduction to make sure that the bone continues to grow normally.

- Plastic deformation of the bone, in which the bone permanently bends, but does not break, also is possible in children. These injuries may require an osteotomy (bone cut) to realign the bone if it is fixed and cannot be realigned by closed methods.

- Certain fractures mainly occur in children, including fracture of the clavicle and supracondylar fracture of the humerus.

Galeazzi fractures account for 3-7% of all forearm fractures. They are seen most often in males. Although Galeazzi fracture patterns are reportedly uncommon, they are estimated to account for 7% of all forearm fractures in adults. They are associated with a fall on an outstretched arm.

These fractures can take at least 4–6 months to heal. Since femoral shaft fractures are associated with violent trauma, there are many adverse outcomes, including fat embolism, acute respiratory distress syndrome (ARDS), multisystem organ failure, and shock associated with severe blood loss. Open fractures can result in infection, osteomyelitis, and sepsis.

The healing time for a routine mandible fractures is 4–6 weeks whether MMF or rigid internal fixation (RIF) is used. For comparable fractures, patients who received MMF will lose more weight and take longer to regain mouth opening, whereas, those who receive RIF have higher infection rates.

The most common long-term complications are loss of sensation in the mandibular nerve, malocclusion and loss of teeth in the line of fracture. The more complicated the fracture (infection, comminution, displacement) the higher the risk of fracture.

Condylar fractures have higher rates of malocclusion which in turn are dependent on the degree of displacement and/or dislocation. When the fracture is intracapsular there is a higher rate of late-term osteoarthritis and the potential for ankylosis although the later is a rare complication as long as mobilization is early. Pediatric condylar fractures have higher rates of ankylosis and the potential for growth disturbance.

Rarely, mandibular fracture can lead to Frey's syndrome.

Clavicle fractures occur at 30–64 cases per 100,000 a year and are responsible for 2.6–5.0% of all fractures. This type of fracture occurs more often in males. About half of all clavicle fractures occur in children under the age of seven and is the most common pediatric fracture. Clavicle fractures involve roughly 5% of all fractures seen in hospital emergency admissions. Clavicles are the most commonly broken bone in the human body.

Smokers generally have lower bone density than non-smokers, so have a much higher risk of fractures. There also is evidence that smoking delays bone healing.

The Pink and Pulseless hand in supracondylar fracture has been assigned the following causes:

1. tear or entrapment of the brachial artery

2. spasm of the artery and

3. compression of the artery relieved by manipulation of the fracture

4. compression of median nerve.

Thus there is loss of circulation of forearm, causing lack of reperfusion of tissues resulting in tissue death causing compartment syndrome.

Therefore, the complications of elbow dislocations include the following:

- Posttraumatic periarticular calcification, which occurs in 3-5% of elbow injuries

- Myositis ossificans or calcific tendinitis

- Neurovascular injuries (8-21% of cases) — palsy to the anterior interosseus nerve at time of index injury is most common, followed by brachial artery injuries (5-13%). Injury to the ulnar nerve is reported with percutaneous pinning through the medial epicondyle.

- Osteochondral defects, intra-articular loose bodies, and avascular necrosis of the capitulum

- Instability

Tibial plateau fractures constitute 1% of all fractures. Peak age is 30–40 years old in men and 60-70 in women. Approximately half of the people who sustain a tibial plateau fracture are aged over 50 years old.

It occurs commonly in adolescents and older children. However, it does occur rarely in adults though it may be under reported because of difficulty in diagnosis.

A common cause is the supracondylar fracture of humerus. It can be corrected via a corrective osteotomy of the humerus and either internal or external fixation of the bone until union.