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Chapter 4 - Upper extremity trauma

from Section I - Skeletal trauma

Published online by Cambridge University Press:  05 September 2015

By
Paul K. Kleinman
Edited by
Paul K. Kleinman
Paul K. Kleinman
Affiliation:
Department of Radiology, Boston Children’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA
Paul K. Kleinman
Affiliation:
Children's Hospital Boston
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Summary

The humerus

The humerus is one of the most frequently injured bones in abused children. In Caffey’s original report of long bone injuries and subdural hematomas (SDHs), three of six cases had bilateral humeral fractures (1). Caffey’s correspondence with Ingraham revealed an additional case of a humeral fracture with SDH (1, 2). Reports that followed included examples of humeral lesions (3–9). Studies of fractures in abused children have found the humerus to be the second or third most common long bone fracture, following the tibia and/or femur (10–15). In their 2007 review of the US Kids’ national database Loder and Feinberg found that the humerus was the third most common long bone region to be fractured (N = 74) in abused infants, exceeded by the femur (N = 150) and the tibia/fibula/ankle (N = 98) (15). Among children 1–2 years of age the number of humeral fractures was slightly greater than the number of femur fractures (N = 28 vs. N = 26). Similarly, in their study of 500 abused children less than 4 years old, Pandya et al. found that the humerus was the third most common long bone region fractured (8.6%), preceded by the femur (14.6%) and tibia/fibula (11%) (16). When broken down by age, the proportions of children under 18 months with fractures involving the femur, tibia/fibula, and humerus were 17.5%, 13.3%, and 9.8% respectively, versus 5.7%, 4.1%, and 4.9% for children greater than 18 months.

Several authors have found the humerus to be the most common long bone injury (17–19). These frequencies vary, depending on the types of populations studied, age distribution, and imaging techniques employed. When high-detail skeletal surveys (SSs) are performed in infant fatalities, metaphyseal injuries of the femurs and tibias tend to predominate, and, thus, the humerus is a less common site of injury than the lower extremities in this younger age group (20). In a review of 567 high-detail SSs done for suspected infant abuse, fractures of the humerus were less common than the long bones of the lower extremities (21).

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Diagnostic Imaging of Child Abuse , pp. 121 - 163
Publisher: Cambridge University Press
Print publication year: 2015

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References

Caffey, J. Multiple fractures in the long bones of infants suffering from chronic subdural hematoma. AJR Am J Roentgenol. 1946;56(2):163–73.Google Scholar
Ingraham, F, Heyl, H. Subdural hematoma in infancy and childhood. JAMA. 1939;112(3):198–204.CrossRefGoogle Scholar
Bakwin, H. Roentgenologic changes in the bones following trauma in infants. J Newark Beth Israel Hosp. 1952;3:17–25.Google Scholar
Bakwin, H. Multiple skeletal lesions in young children due to trauma. J Pediatr. 1956;49:7–15.CrossRefGoogle ScholarPubMed
Jones, H, Davis, J. Multiple traumatic lesions of the infant skeleton. Stanford Med Bull. 1957;15:259–73.Google ScholarPubMed
Kugelmann, J. Uber symmetrische spontanfrakturen unbekannter genese beim saugling. Ann Paediatr (Gr). 1952;178:177–81.Google Scholar
Marie, J, Apostolides, P, Salet, J, Eliachar, E, Lyon, G. Hematome sous-dural-du nourrisson associe a des fractures des membres. Ann Pediatr (Paris). 1954;30:1757–63.Google Scholar
Silverman, F. The roentgen manifestations of unrecognized skeletal trauma in infants. AJR Am J Roentgenol. 1953;69(3):413–27.Google ScholarPubMed
Smith, M. Subdural hematoma with multiple fractures. Case report. AJR. 1950;63:342–4.Google Scholar
Galleno, H, Oppenheim, WL. The battered child syndrome revisited. Clin Orthop Relate Res. 1982(162):11–19.
Herndon, WA. Child abuse in a military population. J Pediatr Orthop. 1983;3(1):73–6.CrossRefGoogle Scholar
Kowal-Vern, A, Paxton, TP, Ros, SP, Lietz, H, Fitzgerald, M, Gamelli, RL. Fractures in the under-three-year-old age cohort. Clin Pediatr. 1992;31(11):653–9.CrossRefGoogle Scholar
Loder, RT, Bookout, C. Fracture patterns in battered children. J Orthop Trauma. 1991;5(4):428–33.CrossRefGoogle ScholarPubMed
Worlock, P, Stower, M, Barbor, P. Patterns of fractures in accidental and non-accidental injury in children: a comparative study. BMJ (Clin Res Ed). 1986;293(6539):100–2.CrossRefGoogle ScholarPubMed
Loder, RT, Feinberg, JR. Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids’ inpatient database. J Pediatr Orthop. 2007;27(4):421–6.CrossRefGoogle ScholarPubMed
Pandya, NK, Baldwin, K, Wolfgruber, H, Christian, CW, Drummond, DS, Hosalkar, HS. Child abuse and orthopaedic injury patterns: analysis at a level I pediatric trauma center. J Pediatr Orthop. 2009;29(6):618–25.CrossRefGoogle Scholar
Akbarnia, B, Torg, J, Kirkpatrick, J, Sussman, S. Manifestations of the battered-child syndrome. J Bone Joint Surg Am. 1974;56(6):1159–66.CrossRefGoogle ScholarPubMed
King, J, Diefendorf, D, Apthorp, J, Negrete, VF, Carlson, M. Analysis of 429 fractures in 189 battered children. J Pediatr Orthop. 1988;8(5):585–9.Google ScholarPubMed
O’Neill, JA, Meacham, WF, Griffin, JP, Sawyers, JL. Patterns of injury in the battered child syndrome. J Trauma. 1973;13(4):332–9.CrossRefGoogle ScholarPubMed
Kleinman, PK, Marks, SC, Richmond, JM, Blackbourne, BD. Inflicted skeletal injury: a postmortem radiologic–histopathologic study in 31 infants. AJR. 1995;165(3):647–50.CrossRefGoogle ScholarPubMed
Barber, I, Perez-Rossello, JM, Wilson, C, Kleinman, PK. The high-detail yield of radiographic skeletal surveys in suspected infant abuse. Pediatr Radiol. 2015;45(1):69–80.CrossRef
Shaw, SA, Murphy, KM, Shaw, A, Oppenheim, WL, Myracle, MR. Humerus shaft fractures in young children: accident or abuse?J Pediatr Orthop. 1997;17(3):293–7.CrossRefGoogle ScholarPubMed
Strait, RT, Siegel, RM, Shapiro, RA. Humeral fractures without obvious etiologies in children less than three years of age: when is it abuse?Pediatrics. 1995;96(4 Pt. 1):667–71.Google Scholar
Thomas, SA, Rosenfield, NS, Leventhal, JM, Markowitz, RI. Long-bone fractures in young children: distinguishing accidental injuries from child abuse. Pediatrics. 1991;88(3):471–6.Google ScholarPubMed
Kemp, AM, Dunstan, F, Harrison, S, Morris, S, Mann, M, Rolfe, K, et al. Patterns of skeletal fractures in child abuse: systematic review. BMJ. 2008;337:a1518.CrossRefGoogle ScholarPubMed
Loder, RT, O’Donnell, PW, Feinberg, JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006;26(5):561–6.CrossRefGoogle ScholarPubMed
Pandya, NK, Baldwin, KD, Wolfgruber, H, Drummond, DS, Hosalkar, HS. Humerus fractures in the pediatric population: an algorithm to identify abuse. J Pediatr Orthop B. 2010;19(6):535–41.CrossRefGoogle ScholarPubMed
Maguire, S, Cowley, L, Mann, M, Kemp, A. What does the recent literature add to the identification and investigation of fractures in child abuse: an overview of review updates 2005–2013. Evid Based Child Health. 2013;8:2044–57.CrossRefGoogle Scholar
Snedecor, S, Knapp, R, Wilson, H. Traumatic ossifying periostitis of the newborn. Surg Gynecol Obstet. 1935;61:385–7.Google Scholar
Snedecor, S, Wilson, H. Some obstetrical injuries to the long bones. J Bone Joint Surg. 1949;31A:378–84.CrossRefGoogle ScholarPubMed
Broker, FH, Burbach, T. Ultrasonic diagnosis of separation of the proximal humeral epiphysis in the newborn. J Bone Joint Surg Am. 1990;72(2):187–91.CrossRefGoogle ScholarPubMed
Maguire, S, Mann, M. Systematic reviews of bruising in relation to child abuse-what have we learnt: an overview of review updates. Evid Based Child Health. 2013;8(2):255–63.CrossRefGoogle ScholarPubMed
Valvano, TJ, Binns, HJ, Flaherty, EG, Leonhardt, DE. Does bruising help determine which fractures are caused by abuse?Child Maltreat. 2009;14(4):376–81.CrossRefGoogle ScholarPubMed
Ogden, JA. Injury to the growth mechanisms. In Skeletal Injury In The Child, 3rd edn. New York, NY: Springer; 2000, pp. 147–208.Google Scholar
Kleinman, PK, Belanger, PL, Karellas, A, Spevak, MR. Normal metaphyseal radiologic variants not to be confused with findings of infant abuse. AJR. 1991;156(4):781–3.CrossRefGoogle Scholar
Kleinman, PK, Marks, SC. A regional approach to the classic metaphyseal lesion in abused infants: the proximal humerus. AJR. 1996;167(6):1399–403.CrossRefGoogle ScholarPubMed
Kleinman, PK, Marks, SCRelationship of the subperiosteal bone collar to metaphyseal lesions in abused infants. J Bone Joint Surg Am. 1995;77(10):1471–6.CrossRefGoogle ScholarPubMed
LaCroix, P. Origin of the perichondrial osseous ring. First example of a phenomenon of induction in skeletal development. In LaCroix, P, ed. The Organization of Bones. Philadelphia, PA: Blakiston Co.; 1951, pp. 90–7.Google Scholar
Oestreich, AE, Ahmad, BS. The periphysis and its effect on the metaphysis. I. Definition and normal radiographic pattern. Skeletal Radiol. 1992;21(5):283–6.CrossRefGoogle ScholarPubMed
Ranvier, L. Quelques faits relatis au developpement du tissue osseux. Comptes Rend Acad Sci. 1873;77:1105.Google Scholar
Jee, WSS. The skeletal tissues. In Weiss, L, ed. Histology Cell and Tissue Biology, 5th edn. New York, NY: Elsevier; 1983, pp. 238–43.Google Scholar
Kleinman, PK, Marks, SC, Blackbourne, B. The metaphyseal lesion in abused infants: a radiologic–histopathologic study. AJR. 1986;146(5):895–905.CrossRefGoogle ScholarPubMed
Tsai, A, McDonald, AG, Rosenberg, AE, Gupta, R, Kleinman, PK. High-resolution CT with histopathologic correlates of the classic metaphyseal lesion of infant abuse. Pediatr Radiol. 2014;44(2):124–40.CrossRefGoogle Scholar
Caffey, J. Some traumatic lesions in growing bones other than fractures and dislocations: clinical and radiological features. Br J Radiol. 1957;30:225–38.CrossRefGoogle ScholarPubMed
Kleinman, PK, Marks, SC, Spevak, MR, Belanger, PL, Richmond, JM. Extension of growth-plate cartilage into the metaphysis: a sign of healing fracture in abused infants. AJR. 1991;156(4):775–9.CrossRefGoogle ScholarPubMed
Kleinman, PK, Nimkin, K, Spevak, MR, Rayder, SM, Madansky, DL, Shelton, YA, et al. Follow-up skeletal surveys in suspected child abuse. AJR. 1996;167(4):893–6.CrossRefGoogle ScholarPubMed
Kogutt, MS, Swischuk, LE, Fagan, CJ. Patterns of injury and significance of uncommon fractures in the battered child syndrome. AJR Am J Roentgenol Radium Ther Nucl Med. 1974;121(1):143–9.CrossRefGoogle ScholarPubMed
Krivine, F, Deffez, J. Le syndrome de Silverman en stomatologie. Rev Stomatol Chir Maxillofac (Fr). 1973;74:343–52.Google Scholar
Osier, LK, Marks, SC, Kleinman, PK. Metaphyseal extensions of hypertrophied chondrocytes in abused infants indicate healing fractures. J Pediatr Orthop. 1993;13(2):249–54.Google ScholarPubMed
Silverman, FN. Radiology and other imaging procedures. In Helfer, RE, Kempe, RS, eds. The Battered Child, 4th edn. Chicago, IL: University of Chicago Press; 1987, pp. 223–46.Google Scholar
Salter, R, Harris, W. Injuries involving the epiphyseal plate. J Bone Joint Surg. 1963;45A:587–622.CrossRefGoogle Scholar
Merten, DF, Kirks, DR, Ruderman, RJ. Occult humeral epiphyseal fracture in battered infants. Pediatr Radiol. 1981;10(3):151–4.CrossRefGoogle ScholarPubMed
Ekengren, K, Bergdahl, S, Ekstrom, G. Birth injuries to the epiphyseal cartilage. Acta Radiol Diagn (Stockh). 1978;19(1B):197–204.CrossRefGoogle ScholarPubMed
Kleinman, PK, Akins, CM. The “vanishing” epiphysis: sign of Salter type I fracture of the proximal humerus in infancy. Br J Radiol. 1982;55(659):865–7.CrossRefGoogle ScholarPubMed
Nicastro, JF, Adair, DM. Fracture-dislocation of the shoulder in a 32-month-old child. J Pediatr Orthop. 1982;2(4):427–9.CrossRefGoogle Scholar
Leventhal, JM, Thomas, SA, Rosenfield, NS, Markowitz, RI. Fractures in young children. Distinguishing child abuse from unintentional injuries. Am J Dis Child. 1993;147(1):87–92.CrossRefGoogle ScholarPubMed
Karmazyn, B, Duhn, RD, Jennings, SG, Wanner, MR, Tahir, B, Hibbard, R, et al. Long bone fracture detection in suspected child abuse: contribution of lateral views. Pediatr Radiol. 2012;42:463–9.CrossRefGoogle ScholarPubMed
Cameron, CM, Rae, L. Radiological diagnosis. Differential diagnosis. Atlas of the Battered Child Syndrome. London: Churchill Livingstone; 1975, pp. 20–50.Google Scholar
Smith, R. Observations on disjunction of the lower epiphysis of the humerus. Dublin Q J Med Sci. 1850;9:63–74.CrossRefGoogle Scholar
Rogers, LF, Rockwood, CASeparation of the entire distal humeral epiphysis. Radiology. 1973;106(2):393–400.CrossRefGoogle ScholarPubMed
Chand, K. Epiphyseal separation of distal humeral epiphysis in an infant. A case report and review of literature. J Trauma. 1974;14(6):521–6.CrossRefGoogle Scholar
DeLee, JC, Wilkins, KE, Rogers, LF, Rockwood, CA. Fracture-separation of the distal humeral epiphysis. J Bone Joint Surg. 1980;62(1):46–51.CrossRefGoogle ScholarPubMed
Nimkin, K, Teeger, S, Wallach, MT, DuVally, JC, Spevak, MR, Kleinman, PK. Adrenal hemorrhage in abused children: imaging and postmortem findings. AJR. 1994;162(3):661–3.CrossRefGoogle ScholarPubMed
Dias, JJ, Lamont, AC, Jones, JM. Ultrasonic diagnosis of neonatal separation of the distal humeral epiphysis. J Bone Joint Surg Br. 1988;70(5):825–8.CrossRefGoogle ScholarPubMed
Siffert, R. Displacement of the distal humeral epiphysis in the newborn infant. J Bone Joint Surg. 1963;45A:165–9.CrossRefGoogle Scholar
Nimkin, K, Kleinman, PK, Teeger, S, Spevak, MR. Distal humeral physeal injuries in child abuse: MR imaging and ultrasonography findings. Pediatr Radiol. 1995;25(7):562–5.CrossRefGoogle ScholarPubMed
Beltran, J, Rosenberg, ZS, Kawelblum, M, Montes, L, Bergman, AG, Strongwater, A. Pediatric elbow fractures: MRI evaluation. Skeletal Radiol. 1994;23(4):277–81.CrossRefGoogle ScholarPubMed
Davidson, RS, Markowitz, RI, Dormans, J, Drummond, DS. Ultrasonographic evaluation of the elbow in infants and young children after suspected trauma. J Bone Joint Surg. 1994;76(12):1804–13.CrossRefGoogle ScholarPubMed
Markowitz, RI, Davidson, RS, Harty, MP, Bellah, RD, Hubbard, AM, Rosenberg, HK. Sonography of the elbow in infants and children. AJR. 1992;159(4):829–33.CrossRefGoogle ScholarPubMed
Ziv, N, Litwin, A, Katz, K, Merlob, P, Grunebaum, M. Definitive diagnosis of fracture-separation of the distal humeral epiphysis in neonates by ultrasonography. Pediatr Radiol. 1996;26(7):493–6.CrossRefGoogle ScholarPubMed
Cummings, RJ, Jones, ET, Reed, FE, Mazur, JM. Infantile dislocation of the elbow complicating obstetric palsy. J Pediatr Orthop. 1996;16(5):589–93.CrossRefGoogle ScholarPubMed
Danielsson, LG, Theander, G. Traumatic dislocation of the radial head at birth. Acta Radiol Diagn (Stockh). 1981;22(3B):379–82.CrossRefGoogle ScholarPubMed
Quigley, AJ, Stafrace, S. Skeletal survey normal variants, artefacts and commonly misinterpreted findings not to be confused with non-accidental injury. Pediatr Radiol. 2014;44(1):82–93.CrossRefGoogle Scholar
Glaser, K. Double contour, cupping and spurring in roentgenograms of long bones in infants. AJR. 1949;61:482–92.Google ScholarPubMed
Park, EA. The imprinting of nutritional disturbances on growing bones, Part II. Pediatrics. 1964;33(Suppl.):815–19.Google Scholar
Johnson, CF, Kaufman, KL, Callendar, C. The hand as a target organ in child abuse. Clin Pediatr. 1990;29(2):66–72.CrossRefGoogle ScholarPubMed
Barrett, IR, Kozlowski, K. The battered child syndrome. Australas Radiol. 1979;23(1):72–82.CrossRefGoogle ScholarPubMed
Merten, DF, Radkowski, MA, Leonidas, JC. The abused child: a radiological reappraisal. Radiology. 1983;146(2):377–81.CrossRefGoogle ScholarPubMed
Woolley, PV. Evans, WA. Significance of skeletal lesions in infants resembling those of traumatic origin. JAMA. 1955;158(7):539–43.CrossRefGoogle ScholarPubMed
Fisher, S. Skeletal manifestations of parent-induced trauma in infants and children. South Med J. 1958;51:956–60.CrossRefGoogle ScholarPubMed
Fairburn, A, Hunt, A. Caffey’s “third syndrome”: a critical evaluation (“the battered baby”). Med Sci Law. 1964;4:123–6.CrossRefGoogle Scholar
Weigel, W, Kaufmann, HJ. Der verschleierte Pflegeschaden. [Child abuse and neglect.]Rontgenblatter. 1975;28(10):463–70.Google Scholar
Nimkin, K, Spevak, MR, Kleinman, PK. Fractures of the hands and feet in child abuse: imaging and pathologic features. Radiology. 1997;203(1):233–6.CrossRefGoogle ScholarPubMed
Karmazyn, D, Lewis, ME, Jennings, SG, Hibbard, RA, Hicks, RA. The prevalence of uncommon fractures on skeletal surveys performed to evaluate for suspected abuse in 930 children: should practice guidelines change?AJR. 2011;197(1):W159–63.CrossRefGoogle Scholar
Jha, P, Stein-Wexler, R, Coulter, K, Seibert, A, Li, CS, Wootton-Gorges, SL. Optimizing bone surveys performed for suspected non-accidental trauma with attention to maximizing diagnostic yield while minimizing radiation exposure: utility of pelvic and lateral radiographs. Pediatr Radiol. 2013;43(6):668–72.CrossRefGoogle ScholarPubMed
Lindberg, DM, Harper, NS, Laskey, AL, Berger, RP. Prevalence of abusive fractures of the hands, feet, spine, or pelvis on skeletal survey: perhaps “uncommon” is more common than suggested. Pediatr Emerg Care. 2013;29(1):26–9.CrossRefGoogle ScholarPubMed
Kleinman, PK, Morris, NB, Makris, J, Moles, RL, Kleinman, PL. Yield of radiographic skeletal surveys for detection of hand, foot, and spine fractures in suspected child abuse. AJR AM J Roentgenol. 2013;200(3):641–4.CrossRefGoogle ScholarPubMed
Jacobs, JC. The differential diagnosis of arthritis in childhood. In Jacobs, JC, ed. Pediatric Rheumatology for the Practitioner. New York, NY: Springer-Verlag; 1993, pp. 122–6.CrossRefGoogle Scholar
Maroteaux, P, Fessard, C, Aron, J, Lamy, M. Les sequelles du syndrome de Silverman (fractures multiples du nourrisson, syndrome dit des “enfants battus”): etudes de seize observations. Presse Med. 1967;75:711–16.Google Scholar
Harris, VJ, Lorand, MA, Fitzpatrick, JJ, Soter, DK. Multiple fractures. In Harris, VJ, Lorand, MA, Fitzpatrick, JJ, Soter, DK, eds. Radiographic Atlas of Child Abuse: A Case Studies Approach. New York, NY: Igaku-Shoin; 1996, pp. 159–62.Google Scholar
Radkowski, MA. The battered child syndrome: pitfalls in radiological diagnosis. Pediatr Ann. 1983;12(12):894–903.CrossRefGoogle ScholarPubMed
Swischuk, LE. Radiographic signs of skeletal trauma. In Ludwig, S, Kornberg, AE, eds. Child Abuse: A Medical Reference, 2nd edn. New York, NY: Churchill Livingstone; 1992, pp. 151–74.Google Scholar
Helfer, RE, Scheurer, SL, Alexander, R, Reed, J, Slovis, TL. Trauma to the bones of small infants from passive exercise: a factor in the etiology of child abuse. J Pediatr. 1984;104(1):47–50.CrossRefGoogle ScholarPubMed
Conway, JJ, Collins, M, Tanz, RR, Radkowski, MA, Anandappa, E, Hernandez, R, et al. The role of bone scintigraphy in detecting child abuse. Semin Nucl Med. 1993;23(4):321–33.CrossRefGoogle ScholarPubMed
Drubach, LA, Johnston, PR, Newton, AW, Perez-Rossello, JM, Grant, FD, Kleinman, PK. Skeletal trauma in child abuse: detection with 18F-NaF PET. Radiology. 2010;255(1):173–81.CrossRefGoogle ScholarPubMed
Rao, KS, Hyde, I. Digital lesions in non-accidental injuries in children. Br J Radiol. 1984;57(675):259–60.CrossRefGoogle ScholarPubMed

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  • Upper extremity trauma
    • By Paul K. Kleinman, Department of Radiology, Boston Children’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA
  • Edited by Paul K. Kleinman
  • Book: Diagnostic Imaging of Child Abuse
  • Online publication: 05 September 2015
  • Chapter DOI: https://doi.org/10.1017/CBO9780511862366.012
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  • Upper extremity trauma
    • By Paul K. Kleinman, Department of Radiology, Boston Children’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA
  • Edited by Paul K. Kleinman
  • Book: Diagnostic Imaging of Child Abuse
  • Online publication: 05 September 2015
  • Chapter DOI: https://doi.org/10.1017/CBO9780511862366.012
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  • Upper extremity trauma
    • By Paul K. Kleinman, Department of Radiology, Boston Children’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA
  • Edited by Paul K. Kleinman
  • Book: Diagnostic Imaging of Child Abuse
  • Online publication: 05 September 2015
  • Chapter DOI: https://doi.org/10.1017/CBO9780511862366.012
Available formats
×