TY  - JOUR
PY  - 2018//
TI  - Abuse as a cause of childhood fractures
JO  - Deutsches Ärzteblatt International
A1  - Berthold, Oliver
A1  - Frericks, Bernd
A1  - John, Thilo
A1  - Clemens, Vera
A1  - Fegert, Jörg M.
A1  - Moers, Arpad von
SP  - 769
EP  - 775
VL  - 115
IS  - 46
N2  - 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>
LA  - en
SN  - 1866-0452
UR  - http://dx.doi.org/10.3238/arztebl.2018.0769
ID  - ref1
ER  -