@article{ref1,
title="Abuse as a cause of childhood fractures",
journal="Deutsches Ärzteblatt International",
year="2018",
author="Berthold, Oliver and Frericks, Bernd and John, Thilo and Clemens, Vera and Fegert, Jörg M. and Moers, Arpad von",
volume="115",
number="46",
pages="769-775",
abstract="BACKGROUND: It is well known that physical abuse of children all too often escapes detection. Fractures are among the potential consequences of physical abuse but are also com- mon in childhood because of accidents. A question frequently addressed to the Medical Child Protection Hotline (Medizini- sche Kinderschutzhotline) is how fractures due to abuse can be distinguished from accidental fractures. <br><br>METHODS: This review is based on pertinent publications retrieved by a search in PubMed and in the Cochrane Data- base, as well as on the authors' experience in a pediatric emergency department with ca. 29 000 consultations per year and in a child protection outpatient clinic with ca. 100 consultations per year. <br><br>RESULTS: Fractures due to abuse are especially common among infants; their incidence is estimated at 56.8/100 000 among infants less than six months old and 39.8/100 000 among infants aged 6 to 11 months. In consideration of the age of the child, the type of fracture, the history, and other factors, a high probability of abuse can be suspected in many cases, so that further measures can be initiated. <br><br>CONCLUSION: All physicians involved in the care of children (even if only occasionally) should be aware of the major indicators of likely physical abuse and of the available oppor- tunities for counseling and intervention. Failures to diagnose child abuse are associated with high rates of recurrence and mortality.<p /> <p>Language: en</p>",
language="en",
issn="1866-0452",
doi="10.3238/arztebl.2018.0769",
url="http://dx.doi.org/10.3238/arztebl.2018.0769"
}