Citation

Powell-Doherty RD, Raynor NE, Goodenow DA, Jacobs DG, Stallion A. Am. J. Surg. 2016; 213(4): 606-610.

Affiliation

Levine Children's Hospital, Department of Pediatric Surgery and the FH "Sammy" Ross Trauma Center, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Anthony.Stallion@carolinashealthcare.org.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2016.12.004

PMID

28007317

Abstract

BACKGROUND: Diagnosing NAT (non-accidental trauma) includes a skeletal survey to identify injuries. A follow-up survey is performed for missed injuries. This study examines the necessity of follow-up surveys.

METHODS: The trauma database identified cases of suspected NAT in <4 years olds (2013-2014). Data were stratified by survey, age, injury, then analyzed for the prevalence of findings. All analyses (relative risk, prevalence and odds ratios) utilized RealStats Resource Pack (Trento, Italy).

RESULTS: 79% positive initial findings and no new follow up findings. Those with negative initial imaging, had no missed injuries. Initial scans were 27.6X more likely to be positive. Fractured skull (31.3), femur (17.2) and ribs (15.7) were the most prevalent. No pelvic fractures and <1% spinal injuries despite both having the greatest radiation exposure. Repeat scans rarely identify findings for age >12 months.

CONCLUSIONS: Follow-up skeletal surveys maybe unnecessary without clinical evidence. Uncommon pelvic and spinal fractures may warrant exclusion from surveys unless clinically indicated.

Copyright © 2016 Elsevier Inc. All rights reserved.

Language: en