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Metaphyseal bucket handle and corner fractures are almost pathognomonic for child abuse
These injuries were originally identified by clinicians evaluating children with subdural hematomas
These injuries are typically seen in the ankles, knees, elbows and wrists
Violent twisting, shaking, or pulling across a joint creates shearing forces across the weak epiphyseal growth plate and metaphysis
This leads to
1) A thin rim of mineralized metaphyseal bone aka “bucket handle”
http://rad.usuhs.mil/rad/home/peds/bucketarrow.jpg
OR
2) Small flecks of bone from the metaphyseal corner adherent to periosteum
http://t2.gstatic.com/images?q=tbn:ANd9GcT0kZ3VR1f7MwRj7oIa6jaYVp_-f8kZ1NhSbw4kCTRGNLDJ1pKK9g