The child's injuries included 26 rib fractures, a broken arm, a broken collar bone, and two punctured lungs.

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Her twin brother was found to have subdural haemorrhages and nine rib fractures.

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They included two punctured lungs, 26 rib fractures and a broken collar bone.

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He said it was difficult to cause rib fractures to a 15-month-old child and that he believed the injuries had not been accidental.

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However, as Red Sox outfielder Jacoby Ellsbury can attest to, rib fractures can linger and be more difficult to recover from than expected.

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Nathan Rawling, of Gravesend, is accused of inflicting life-threatening injuries, including two punctured lungs and 26 rib fractures, in December 2011 during one "catastrophic assault".

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Mr Williams had suffered severe head and face injuries and multiple rib fractures in a "brutal, vicious and sustained attack" with a heavy object, police said.

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An official at the hospital said the man was in critical condition with multiple rib fractures, and that his female companion was also being treated there for a pelvis fracture.

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The paediatric pathologist also said rib fractures on his body, missed by Dr Curtis at the initial post mortem, were inflicted with "considerable force" either through squeezing by someone with big hands or by crushing against a hard surface.

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The report in the journal Injury Prevention found that serious chest and rib cage fractures were very common.

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