Skip to main content
SpringerLink
Log in

General Aspects of Fractures in Child Abuse

  • Chapter
  • First Online:
Forensic Aspects of Pediatric Fractures

Abstract

The incidence and prevalence of child abuse is unknown. The reason for this is that in nearly every study to establish the incidence and prevalence, researchers use their own definition. Sometimes this is a ‘broad definition,’ such as that of the World Health Organisation (WHO): ‘Child abuse, sometimes referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity. Within this broad definition, five subtypes can be distinguished - physical abuse; sexual abuse; neglect and negligent treatment; emotional abuse; and exploitation’ [1]. In other cases a much narrower definition is used by preference. This makes it impossible or nearly impossible to compare the research results for incidence and prevalence. In his report on the occasion of the violent death of Victoria Climbié on 25 February 2000, Lord Laming writes on the incidence and prevalence of child abuse: ‘I have no difficulty in accepting the proposition that this problem (deliberate harm to children) is greater than that of what are generally recognized as common health problems in children, such as diabetes or asthma’ [2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organization. Child maltreatment. http://www.who.int/topics/child_abuse/en/

  2. Laming H. The Victoria Climbié inquiry. http://www.victoria-climbie-inquiry.org.uk/

  3. Coulter K (2000) Bruising and skin trauma. Pediatr Rev 21(1):34-5

    Article  CAS  PubMed  Google Scholar 

  4. Nobuyasu S. Cost and benefit simulation analysis of catastrophic maltreatment. In Franey K, Geffner R, Falconer R eds. The cost of child maltreatment: Who pays? We all do. Family Violence & Sexual Assault Institute, 2001

    Google Scholar 

  5. Stephenson T (1995) Bruising in children. Curr Paediatr 5:225-9

    Article  Google Scholar 

  6. McCurdy, 1993 cited from Nobuyasu S. Cost and benefit simulation analysis of catastrophic maltreatment In Franey K, Geffner R, Falconer R eds. The cost of child maltreatment: Who pays? We all do. Family Violence & Sexual Assault Institute, 2001

    Google Scholar 

  7. McMahon P, Grossman W, Gaffney M et al (1995) Soft tissue injury as an indication of child abuse. J Bone Joint Surg 77(8):1179-83

    CAS  PubMed  Google Scholar 

  8. Cramer KE (1996) Orthopedic aspects of child abuse. Pediatr Clin North Am 43(5):1035-51

    Article  CAS  PubMed  Google Scholar 

  9. Sinal SH, Stewart CD (1998) Physical abuse of children: a review for orthopedic surgeons. J South Orthop Assoc 7(4): 264-76

    CAS  PubMed  Google Scholar 

  10. Holter JC, Friedman SB (1968) Child Abuse: early case finding in the emergency department. Pediatrics 42(1): 128-38

    CAS  PubMed  Google Scholar 

  11. Hyden PW, Gallagher TA (1992) Child abuse intervention in the emergency room. Pediatr Clin North Am 39(5):1053-81

    CAS  PubMed  Google Scholar 

  12. Lucas DR, Wezner KC, Milner JS et al (2002) Victim, perpetrator, family, and incident characteristics of infant and child homicide in the United States Air Force. Child Abuse Negl 26(2):167-86

    Article  PubMed  Google Scholar 

  13. Landin LA (1983) Fracture patterns in children. Analysis of 8, 682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 202:1-109

    CAS  PubMed  Google Scholar 

  14. Landin LA (1997) Epidemiology of children’s fractures. J Pediatr Orthop B 6(2):79-83

    CAS  PubMed  Google Scholar 

  15. Worlock P, Stower M (1986) Fracture patterns in Nottingham children. J Pediatr Orthop 6(6):656-60

    CAS  PubMed  Google Scholar 

  16. Wilkins KE, Aroojis AJ. The present status of children’s fractures. In Beaty JH, Kasser JM eds. Rockwood and Wilkins’ Fractures in children. Lippincott Williams & Wilkins, 5th ed, 2001, 3-20

    Google Scholar 

  17. Rang M, Willis RB (1977) Fractures and sprains. Pediatr Clin North Am 24(4):749-73

    CAS  PubMed  Google Scholar 

  18. Torwalt CR, Balachandra AT, Youngson C et al (2002) Spontaneous fractures in the differential diagnosis of fractures in children. J Forensic Sci 47(6):1340-4

    PubMed  Google Scholar 

  19. MacAusland WR. Sprains, fractures, dislocations. In Nardi GL, Zuidema GD eds. Surgery, a concise guide to clinical practice. Little Brown, 3rd ed, 1972, 945

    Google Scholar 

  20. Worlock P, Stower M, Barbor P (1986) Patterns of fractures in accidental and non-accidental injuries in children: a comparative study. Br Med J 12(6539):100-2

    Article  Google Scholar 

  21. Lyons RA, Delahunty AM, Kraus D et al (1999) Children’s fractures: a population based study. Inj Prev 5(2):129-32

    Article  CAS  PubMed  Google Scholar 

  22. Akbarnia B, Torg JS, Kirkpatrick J et al (1974) Manifestations of the battered child syndrome. J Bone Joint Surg 56(6): 1159-66

    CAS  PubMed  Google Scholar 

  23. King J, Diefendorf D, Apthorp J et al (1988) Analysis of 429 fractures in 189 battered children. J Pediatr Orthop 8(5): 585-9

    CAS  PubMed  Google Scholar 

  24. Leventhal JM, Thomas SA, Rosenfield NS et al (1993) Fractures in young children. Distinguishing child abuse from unintentional injuries. Am J Dis Child 147(1):87-92

    CAS  PubMed  Google Scholar 

  25. Skellern CY, Wood DO, Murphy A et al (2000) Non-accidental fractures in infants: risk of further abuse. J Paediatr Child Health 36(6):590-2

    Article  CAS  PubMed  Google Scholar 

  26. Barsness KA, Cha ES, Bensard DD et al (2003) The positive predictive value of rib fractures as an indicator of nonaccidental trauma in children. J Trauma 54(6):1107-10

    Article  PubMed  Google Scholar 

  27. Merten DF, Radlowski MA, Leonidas JC (1983) The abused child: a radiological reappraisal. Radiology 146(2):377-81

    CAS  PubMed  Google Scholar 

  28. Cadzow SP, Armstrong KL (2000) Rib fractures in infants: Red alert! The clinical features, investigations and child protection outcomes. J Paediatr Child Health 36(4):322-6

    Article  CAS  PubMed  Google Scholar 

  29. Banaszkiewicz PA, Scotland TR, Myerscough EJ (2002) Fractures in children younger than age 1 year: importance of collaboration with child protection services. J Pediatr Orthop 22(6):740-4

    Article  PubMed  Google Scholar 

  30. Oral R, Blum KL, Johnson C (2003) Fractures in young children: are physicians in the emergency department and orthopedic clinics adequately screening for possible abuse? Pediatr Emerg Care 19(3):148-53

    PubMed  Google Scholar 

  31. Kogutt MS, Swischuk LE, Fagan CJ (1974) Patterns of injury and significance of uncommon fractures in the battered child syndrome. Am J Roentgenol Radium Ther Nucl Med 121(1):143-9

    CAS  PubMed  Google Scholar 

  32. Loder RT, Bookout C (1991) Fracture patterns in battered children. J Orthop Trauma 5(4):428-33

    Article  CAS  PubMed  Google Scholar 

  33. Taitz J, Moran K, O’Meara M (2004) Long bone fractures in children under 3 years of age: Is abuse being missed in Emergency Department presentations? J Pediatr Child Health 40(4):170-4

    Article  CAS  Google Scholar 

  34. Kemp AM, Dustan F, Harrison S et al (2008) Patterns of skeletal fractures in child abuse: systematic review. Br Med J 337:a1518

    Article  Google Scholar 

  35. Duhaime AC, Alario AJ, Lewander WJ et al (1992) Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age. Pediatrics 90(2 Pt 1):179-85

    CAS  PubMed  Google Scholar 

  36. Jeerathanyasakun Y, Hiranyavanitch P, Bhummichitra D et al (2003) Causes of femoral shaft fracture in children under five years of age. J Med Assoc Thai 86(Suppl 3): S661-6

    Google Scholar 

  37. Kleinman P, Blackbourne B, Marks S et al (1989) Radiologic contributions to the investigation and prosecution of cases of fatal infant abuse. N Engl J Med 320(8):507-11

    Article  CAS  PubMed  Google Scholar 

  38. Kleinman PK. Diagnostic imaging of child abuse. Williams & Wilkins, 1987

    Google Scholar 

  39. Hobbs C. Fractures. In: Meadow R ed. ABC of child abuse. Br Med J, 3rd ed., 1997,9-13

    Google Scholar 

  40. Hobbs CJ,Hanks HGI, Wynne JM. Child abuse and neglect - a clinician’s handbook. Churchill Livingstone, 1993, 57-65

    Google Scholar 

  41. Paterson CR (1987) Child abuse or copper deficiency? Br Med J 295:213

    Article  CAS  Google Scholar 

  42. Taitz LS (1991) Child abuse and metabolic bone disease: are they often confused? Br Med J 302(6787):1244

    Article  CAS  Google Scholar 

  43. Taitz LS. Child abuse: some myths and shibboleths. Hospital Update 1991:400-4

    Google Scholar 

  44. Mathew MO, Ramamohan N, Bennet GC (1998) Importance of bruising associated with paediatric fractures: prospective observational study. Br Med J 317(7166):1117-8

    CAS  Google Scholar 

  45. Starling SP, Sirotnak AP, Heisler KW et al (2007) Inflicted skeletal trauma: the relationship of perpetrators to their victims. Child Abuse Negl 31(9):993-9

    Article  PubMed  Google Scholar 

  46. Kocher MS, Kasser JR (2000) Orthopaedic aspects of child abuse. J Am Acad Orthop Surg 8(1):10-20

    CAS  PubMed  Google Scholar 

  47. McClain PW, Sacks JJ, Froehlke RG et al (1993) Estimates of fatal child abuse and neglect, United States, 1979 through 1988. Pediatrics 91(2):338-43

    CAS  PubMed  Google Scholar 

  48. Baartman HEM. Opvoeden met alle geweld - hardnekkige gewoontes en hardhandige opvoeders. SWP uitgeverij, 1993, 28-9

    Google Scholar 

  49. Pierce MC, Bertocci GE (2006) Fractures resulting from inflicted trauma: assessing injury and history compatibility. Clin Ped Emerg Med 7(3):143-8

    Article  Google Scholar 

  50. Van Rijn RR, Nijs HGT, Bilo RAC. Evidence based imaging in non-CNS non-accidental injury in Evidence-Based Imaging in Pediatrics Eds. Medina LS, Blackmore CC and Applegate KE Springer (In press)

    Google Scholar 

  51. Society for Pediatric Radiology. Critical review of ‘temporary brittle bone disease’. 2004

    Google Scholar 

  52. Altman DH, Smith RL. Unrecognized trauma in infants and children. J Bone Joint Surg Am 1960;42-A:407-13

    Google Scholar 

  53. O’Neill JA Jr, Meacham WF, Griffin PP et al (1973) Patterns of injury in the battered child syndrome. J Trauma 13(4):332-9

    Article  PubMed  Google Scholar 

  54. Kleinman PK. Skelet trauma: general considerations. In Kleinman PK. Diagnostic imaging of child abuse. Mosby, 2nd ed, 1998, 8-25

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology and Toxicology, Netherlands Forensic Institute, 24044, 2490, AA, The Hague, The Netherlands

    Rob A. C. Bilo MD

  2. Department of Radiology, Maastricht University Medical Center, 5800, 6202, AZ, Maastricht, The Netherlands

    Simon G. F. Robben MD, PhD

  3. Department of Radiology, Emma Children’s Hospital/Academic Medical Center Amsterdam, 22660, 1100, DD, Amsterdam, The Netherlands

    Rick R. van Rijn MD, PhD

Authors
  1. Rob A. C. Bilo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simon G. F. Robben MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rick R. van Rijn MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rob A. C. Bilo MD .

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Bilo, R.A.C., Robben, S.G.F., van Rijn, R.R. (2010). General Aspects of Fractures in Child Abuse. In: Forensic Aspects of Pediatric Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78716-7_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-78716-7_1

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-78715-0

  • Online ISBN: 978-3-540-78716-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation