Child abuse: Non-acute fracture | The University Of Western Ontario - Edubirdie

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

244

Pages:

2
Author:

Kyuwon J.

Child abuse : Non-acute fracture Q) why is non- acute fracture in child classified as abuse? ● Abuse is repetitive ○ Occurring over days/weeks ○ Child may sustain multiple trauma ○ Result fractures of varying age ● Delayed medical attentions ○ Commonly left behind ○ Caregivers don't give out immediate treatment since they are afraid of being caught ● Infants/toddlers are not able to describe their pain descriptively ○ Fracture could be unnoticed for duration of time ● Abusive force such as twisting, compression and shaking will create microfracture/incomplete fractures in duration of time ● Caregivers may cause lower impact injuries ○ Repetitive injury on specific spot ○ Will make healing patterns consistent on older fractures Fracture patterns a/w abuse ● Highly suspicious in non-ambulatory infants ○ Metaphyseal corner fractures (CMLs) ■ Bucket-handle fractures ■ Caused by shearing and twisting force ● Violent shaking/pulling ■ Highly specific on abuse ● <2yo ○ Posterior Rib Fractures ■ Created through anteroposterior chest compression ● Squeezing during shaking ■ a/w inflicted traumas ○ Vertebral fractures or Subluxations ■ Hyperflexion or axial loadings ○ Scapular, Spinous Process, Sternal Fractures ■ Need significant force ■ Rare to find in accidents ○ Multiple fractures in different healing stages ■ Old, subacute fractures ■ Red flag on child abuse Radiologic signs of Non-acute fractures ● Posterior Reactions ○ Soft callus formation on 10 days ■ This will be earlier in infants ○ Symmetric periosteal new bones ■ Healing of fractures ● Callus Formations ○ 2-3 weeks of post-injury ■ Varies by ages ○ More of mineralization over time ● Remodeling ○ Long term healing => Cortical thickening , re-angulations This is present in injuries of different stages of healing = repeated traumas

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