Surveying Non-Accidental Trauma Closely



Fractures occur for roughly 10-25% of all childhood injuries. The overall incidence of fractures in children is approximately 20/1000/year, which is approximate twice the incidence of fractures in adults. The incidence of fractures as we age and approximately a third of children can be expected to undergo a fracture before the age of 16 years. Children sustain mainly an upper limb fracture and have comparatively few lower limb fractures.

Accidents are common, especially among young children aged 1 - 4 years of age. It gets necessary for you, as a parent and guardian or the health workers to be aware of these possible unpleasant and unintended events and should play a big role first in the restriction and secondly in their management. We shall examine both accidental and Non-accidental injuries.

Bone fracture in children:

Long bone fractures in children can occur due to accidental or non-accidental injuries. The identification of some of the non-accidental nature fractures in children remains a major diagnostic challenge for clinicians. The clinical situation is sensitive due to child protection issues and the impact of an incorrect judgment on the child and the family unit.

 Away from the clinical setting, the evidence for the judgment on child abuse must also withstand investigation in the court of law. There should be a waste of considerable resources in the investigation of a misjudged non-accidental injury. It is important for you to be aware of the variation in clinical traits of fractures from accidental and non-accidental injuries.

Fractures and other childhood problems:

In comparison with the other childhood problems, the 'non-accidental fracture' poses distinct diagnostic concerns in that despite the significant risk and the consequences of this diagnosis.

Furthermore, there is no clinical test available that can confirm or exclude non-accidental injury in a child with a fracture. It remains a subjective and qualitative clinical decision which is based on the assessment of an experienced clinician

 The decision is based on the evaluation of the injury, clinical assessment of the child and evaluation of the fracture. The predominance of the non-accidental fractures is hard to measure but these are identified in one in three children investigated for non-accidental injury.

Conclusion:

The purpose of this study was to examine the demographic and injury characteristics of children hospitalized with non-accidental trauma as a causative factor using a large national database. Of the nearly 2.5 million cases in the database, 1794 (0.1%) were identified through diagnostic coding of abuse. Both sexes were equally represented, and two-thirds had Medicaid as their primary payer. About one-half of the children were younger than 1 year, but all ages were represented. The most common orthopedic injuries were fractures of the femur or humerus, and most of those fractures occurred in children younger than 2 years. The most common non-orthopedic injuries were contusions and brain injuries, with or without skull fracture, and 62 (3.5%) of the abused children died.

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Content Source : https://parnamiorthopaedichospital.home.blog/2019/06/19/surveying-non-accidental-trauma-closely/

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