[Retrospective analysis of 5,108 pediatric case files under traumatological and forensic aspects: a contribution to the differential diagnosis of physical child abuse vs. falls].

We retrospectively evaluated 5108 case files from all children and adolescents under 16 years who were treated as in-patients during a four-year-period (2001-2004) in the Pediatric Department of a large University Hospital in Northern Germany. Statistical evaluation was performed with the epidemiologic software Epi Info 6.0. 472 cases where a trauma was diagnosed or suspected upon admission to hospital were further evaluated. Most frequently concerned were children between two and five years and the most common cause for their injuries, according to the anamnesis, were falls. These falls were analysed on the basis of the reported story and the established injury pattern. The height of the falls and the severity of injuries correlated well in most cases. The often critically discussed falling height of about 100 cm. which is obviously often stated by caregivers to cover up nonaccidental injuries, proved to be again the decisive problematic aspect concerning the differentiation between non-accidental (abusive) and accidental injuries.