Peters Melissa L, Starling Suzanne P, Barnes-Eley Myra L, Heisler Kurt W
Pediatric Emergency Medicine, The Children's Hospital of Alabama, 1600 6th Ave S, Midtown Bldg, Ste 205, Birmingham, AL 35233, USA.
Arch Pediatr Adolesc Med. 2008 Sep;162(9):877-81. doi: 10.1001/archpedi.162.9.877.
To determine the occurrence of bruising near the site of fracture in a group of children with inflicted fractures.
Case series.
Two children's hospitals.
Suspected child abuse victims with fractures.
The presence of bruising and fracture in a single body region or appendage.
The study included 192 children with inflicted fractures. No bruising was found in 111 (57.8%) of the study participants. Forty patients (20.8%) had bruising near the site of at least 1 fracture. Of these, bruising or subgaleal hematoma near the site of a skull fracture was seen most often, in 43.3% of patients. Bruising in association with extremity fractures was seen much less commonly, ranging from 3.8% (n = 2) of children with tibia fracture to 16.7% (n = 1) of children with fibula fracture. Rib fractures also were associated uncommonly with bruising. When skull fractures are excluded, 45 (8.1%) of 555 fractures had bruising near the fracture site, in 13 (6.8%) patients.
In children with inflicted skeletal trauma, the fractured bones that most frequently have associated bruising are the skull bones. The presence of bruising near the fracture site is uncommon in extremity or rib fractures.
确定一组受虐骨折儿童骨折部位附近瘀伤的发生率。
病例系列研究。
两家儿童医院。
疑似受虐骨折的儿童受害者。
单个身体区域或肢体中瘀伤和骨折的存在情况。
该研究纳入了192例受虐骨折儿童。111例（57.8%）研究对象未发现瘀伤。40例（20.8%）患者在至少一处骨折部位附近有瘀伤。其中，颅骨骨折部位附近出现瘀伤或帽状腱膜下血肿最为常见，占患者的43.3%。与四肢骨折相关的瘀伤则少见得多，从胫骨骨折儿童的3.8%（n = 2）到腓骨骨折儿童的16.7%（n = 1）不等。肋骨骨折与瘀伤的关联也不常见。排除颅骨骨折后，555处骨折中有45处（8.1%）在骨折部位附近有瘀伤，涉及13例（6.8%）患者。
在受虐骨骼创伤儿童中，最常伴有瘀伤的骨折骨头是颅骨。骨折部位附近出现瘀伤在四肢或肋骨骨折中并不常见。
