Children’s femur, forearm and humeral fractures may indicate instances of repeated abuse
LISBON, Portugal — Many children who sustained one or more instances of abuse presented with long bone fractures, according to findings from researchers at Mahidol University and Faculty of Medicine at Siriraj Hospital in Bangkok.
These fractures were identified in a retrospective study that included 133 children aged 2 months to 15 years and 54 cases of recurrent child abuse. Fractures were seen most often in the femur, forearm and humerus; however, 68% of the injuries that were linked with abuse involved bruises and burns.
Jidapa Wongcharoenwatana , MD, said, “There were two factors associated with a higher risk of recurrence, which was age 1 to 10 years old and significant abusive patterns. So, children at risk should be recognized and sent for intensive child observation and evaluated for abuse.”
For the long bone fractures, the site was typically the diaphysis, she said.
“The majority type of abuse was physical abuse, and the perpetrators were mostly the parents. In the physical abuse cases, the majority of these were bruising and burns for 68.37%, followed by subdural hematoma and fractures for 14. 29%. In the fracture cases, the average age was 2.8 years old, with a location at the femur in 40%,” Wongcharoenwatana said.
The type of abuse and abuser were the two factors that were significantly associated with an increased risk of repeated abuse in children, based on the study findings, which also showed that physical abuse constituted most of the repeated abuse type in these children.
In about 46% or most of the cases, the child’s parents were the abusers. – by Susan M. Rapp
Wongcharoenwatana J, et al. Abstract 1666. Presented at: EFORT Annual Congress; June 5-7, 2019; Lisbon, Portugal.
Disclosure: Healio.com/Orthopedics was unable to confirm Wangcharoenwatana’s relevant financial disclosures.