Patterns of Skeletal Fractures in Child Abuse
Author Information
Author(s): Kemp Alison M, Dunstan Frank, Harrison Sara, Morris Susan, Mann Mala, Rolfe Kim, Datta Shalini, Thomas D Phillip, Sibert Jonathan R, Maguire Sabine
Primary Institution: Cardiff University
Hypothesis
What features differentiate fractures resulting from abuse from those sustained from other causes?
Conclusion
When infants and toddlers present with a fracture without a confirmed cause, physical abuse should be considered as a potential cause.
Supporting Evidence
- Fractures from abuse are more common in infants and toddlers.
- Multiple fractures are more common in cases of abuse.
- Rib fractures have the highest probability of being caused by abuse.
- Humeral fractures have a significant probability of being due to abuse.
- Femoral fractures also indicate a likelihood of abuse, especially in non-walking children.
Takeaway
If a baby or toddler has a broken bone and we don't know why, we should think about the possibility that they might have been hurt on purpose.
Methodology
Systematic review of comparative studies on fractures in children under 18 years old, including meta-analysis where possible.
Potential Biases
Retrospective studies may have incomplete datasets and potential biases in case selection.
Limitations
The review faced challenges due to heterogeneity between studies and the retrospective nature of the included studies.
Participant Demographics
Children under 18 years old, with a focus on infants and toddlers.
Statistical Information
Confidence Interval
0.42 to 0.91 for rib fractures; 0.48 (0.06 to 0.94) for humeral fractures; 0.28 (0.15 to 0.44) for femoral fractures.
Digital Object Identifier (DOI)
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