Forensic Aspects of Pediatric Fractures

About this book

Fractures are a common finding in children and it is estimated that 2.1% of all children will suffer at least one fracture before the age of 16. With young children in particular, the question may arise if this is related to child abuse. The aim of this book is to help physicians involved in child abuse cases to interpret radiological findings in light of the forensic circumstances under which they occurred. The authors present up-to-date literature related to the mechanisms underlying non-accidental cases of trauma.

In this book not only the radiological findings in child-abuse are discussed, but more importantly, these findings are analyzed from a forensic perspective. Careful attention is paid to evidence regarding reported trauma mechanisms and their clinical outcome; for example, can a fall from a couch result in a femoral fracture, and if not, where is the supporting evidence?

Written for:

Clinicians and practitioners

Keywords:

child abuse
forensic medicine
forensic pediatrics
pediatric wounds and injuries

Table of contents

Fractures in child abuse. Incidence of pediatric fractures. Differences between pediatric and adult fractures. Differential diagnosis of pediatric fractures. Fractures and child abuse. The radiologist’s role in child abuse. Ethical dilemmas in child abuse.- Skull. Signs, symptoms and complications. Biomechanical aspects of skull fractures. Skull fracture types. Skull fractures and intra-cranial pathology. Differential diagnosis of accidental and non-accidental skull fractures. Growing skull fractures. Dating skull fractures. Skull base fractures. Craniofacial fractures and dental trauma.- Ribs. Signs, symptoms and complications. Biomechanical aspects of rib fractures. Rib fractures and child abuse. Differential diagnosis of accidental and non-accidental causes of rib fractures.- Clavicle, sternum, scapula, spine and pelvis.- Extremities. Anatomy and physiology of long bones. Diaphyseal fractures. Epiphyseal and metaphyseal fractures. Humerus. Radius and ulna. Femur. Tibia and fibula. Shaft fractures of the lower extremities. Hands and feet. Subperiostal hemorrhage.- Trauma-related differential diagnosis. Birth trauma. Accidental fractures. Fall from low height. Baby walker-related fractures. Baby bouncer-related fractures. Falls from bunk beds. Falls from strollers. Falls from highchairs. Falls from stairs. Falls out of shopping carts. Falls from trampolines.- Disease-related differential diagnosis. Fractures. Radiological differential diagnosis in the absence of fractures. Iatrogenic causes. Temporary brittle bone disease.- Imaging techniques. Conventional radiography. Bone scintigraphy. CT and MRI.- Post mortem imaging. Dating fractures. Medical history and clinical findings. Radiological features. Dating case studies.