Why is there a multi-fold difference in diagnosis of abuse among infants with long bone fracture in East Anglia compared with Sweden?

The multicentre hospital study by Mitchell et al 1 provides interesting regional representative data on limb fractures and diagnosis of physical abuse among young children. Their study enables intercountry considerations of fractures and physical abuse. Abuse was diagnosed in 21.2% (28/132) with long bone fractures (femur/tibia/fibula, radius/ulna/humerus) at age younger than 12 months.1 Among Swedish infants, a corresponding proportion of 2.7% (57/2093) had an abuse diagnosis out of all long bone fractures.2 How is it that the East Anglia Region and Sweden had a multifold difference in the proportion of abuse diagnosis among those with …