Background: Spiral fractures of long bones have long been cited as indications of non-
accidental trauma (NAT) in children; however, fracture types are only loosely defined in the
literature, and intraobserver and interobserver variability in defining femoral fracture patterns
is rarely mentioned. We sought to determine reliability in classifying femoral fractures in
young children using a standard series of radiographs shown to physicians with varied
backgrounds and training and to determine if a quantitative approach based on objective …