Ross Ann H, Juarez Chelsey A
Department of Sociology and Anthropology, North Carolina State University, Raleigh, North Carolina.
Clin Anat. 2016 Oct;29(7):844-53. doi: 10.1002/ca.22683. Epub 2016 Jan 25.
Child abuse in its various types such as physical, emotional, sexual, and neglect has been document throughout history. However, before the mid-20th century, inflicted injuries to children was overlooked in part because children were often viewed as property. According to the World Health Organization, 57,000 children were the victims of homicide in the year 2000. In this paper we present the skeletal and radiological manifestation of physical abuse and fatal neglect and provide recommendations to assess child maltreatment from past populations. Pediatric biomechanical factors and healing are discussed as it is important to keep in mind that children are not just small adults. Skeletal and radiological indicators of nonaccidental or inflicted injuries are reviewed from the literature. Inflicted injuries are presented based on specificity to identify child abuse. In addition, skeletal indicators that could help assess fatal starvation are also reviewed and metabolic diseases are proposed as potential evidence of neglect. A recent child homicide is presented and used to illustrate the difficulty in assessing child maltreatment. Present-day clinical child abuse protocols are used to provide recommendations to assess child abuse in a bioarchaeological context. Clin. Anat. 29:844-853, 2016. © 2016 Wiley Periodicals, Inc.
历史上已记载了各种形式的虐待儿童行为，如身体虐待、情感虐待、性虐待和忽视。然而，在20世纪中叶之前，儿童遭受的伤害在一定程度上被忽视了，部分原因是儿童常常被视为财产。据世界卫生组织统计，2000年有57000名儿童成为杀人案的受害者。在本文中，我们介绍了身体虐待和致命忽视的骨骼及放射学表现，并提供了评估过去人群中儿童虐待情况的建议。鉴于儿童并非只是缩小版的成年人，我们还讨论了儿童生物力学因素及愈合情况。本文从文献中回顾了非意外或受虐伤害的骨骼及放射学指标。基于特异性呈现受虐伤害以识别儿童虐待情况。此外，还回顾了有助于评估致命饥饿的骨骼指标，并提出代谢性疾病作为忽视的潜在证据。文中呈现了一起近期的儿童杀人案，用以说明评估儿童虐待情况的困难。本文运用当今临床儿童虐待诊疗方案，为在生物考古学背景下评估儿童虐待提供建议。《临床解剖学》2016年第29卷：844 - 853页。© 2016威利期刊公司
