@article{ref1,
title="Pediatric skeletal injuries in emergency department; an alarm of child maltreatment in Egypt: a cross-sectional study",
journal="Legal medicine (Elsevier)",
year="2024",
author="Mohammad Moawad, Asmaa and Mohamed Ibraheim Moawad, Eman and Ali Mohamed Mahrous, Mohamed and Zein, Marwa M. and Salama Mahmoud Mahmoud, Amal",
volume="70",
number="",
pages="e102471-e102471",
abstract="BACKGROUND: Child physical abuse, a type of child maltreatment (CM), poses a significant global public health concern. Nonaccidental fractures and soft tissue injuries, which encompass any action that directly or indirectly harms a child, are the primary indicators of physical abuse in children. <br><br>OBJECTIVE: This study aimed to investigate the prevalence, risk factors, and outcomes of accidental and nonaccidental skeletal fractures in a sample of Egyptian children. <br><br>METHODS: A cross-sectional analytical study was conducted between March 2022 and August 2022. A total of 156 children who presented with skeletal injuries and attended Mobarak Central Hospital were enrolled. Patients were subjected to full history taking, complete examination, and investigations. A structured questionnaire was administered to all the legal guardians. <br><br>RESULTS: Physical abuse was reported in 22.4 % of cases, while medical neglect was reported in 19.9 % of cases. The incidence of physical abuse was notably higher among children whose fathers were smokers and/or drug addicts (p ≤ 0.05). The most common form of physical abuse was hitting (94.3 %). Among skeletal injuries, fractures were predominant (94.3 %), primarily closed fractures associated with contusions. Fractures of the upper limb accounted for the highest incidence (94.3 %) of skeletal injuries, and 60 % of physically abused children experienced moderate-severity injuries. <br><br>CONCLUSION: The most common fracture observed in abused children is the upper limb fracture, typically involving a single bone. Clinicians should be more vigilant in suspecting abuse, even in cases where there is an isolated fracture, and advocate for the development of parental training programs.<p /> <p>Language: en</p>",
language="en",
issn="1344-6223",
doi="10.1016/j.legalmed.2024.102471",
url="http://dx.doi.org/10.1016/j.legalmed.2024.102471"
}