Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, 593 Eddy Street, Providence, RI, USA.
Department of Pediatrics, The Lawrence A. Aubin Sr. Child Protection Center, Hasbro Children's Hospital, Brown University, Warren Alpert School of Medicine, 593 Eddy Street, Providence, RI, USA.
Pediatr Res. 2022 Sep;92(3):647-652. doi: 10.1038/s41390-021-01850-7. Epub 2021 Nov 24.
Child abuse is common in the United States but is often undetected. The incidence of this form of abuse is difficult to quantify, but children with a history of abuse are at risk of chronic health conditions. Medical providers are in the unique position of triaging trauma patients and differentiating unintentional from abusive trauma, as well as having the important position of being a mandated reporter of abuse in all states. Obtaining a detailed history and screening for risk factors can help identify children at risk of abuse. Certain orthopedic injuries may be related to abuse, which may trigger clinical suspicion and lead to further workup or intervention. By increasing awareness, through medical provider education and increased screening, earlier detection of abuse may prevent more serious injuries and consequences. This review evaluates current literature regarding the orthopedic manifestations of child abuse in hopes of increasing medical provider awareness. IMPACT: Child abuse is common in the United States but often remains undetected. Medical professionals are in the unique position of evaluating trauma patients and identifying concerns for abusive injuries. Certain orthopedic injuries may raise concern for abuse triggering clinical suspicion and further workup or intervention.
儿童虐待在美国很常见,但往往未被发现。这种虐待形式的发生率很难量化,但有虐待史的儿童有患慢性健康问题的风险。医疗服务提供者在对创伤患者进行分诊和区分意外伤害与虐待性创伤方面具有独特的地位,并且在所有州都具有作为虐待行为强制报告者的重要地位。获取详细的病史和筛查风险因素有助于识别有虐待风险的儿童。某些骨科损伤可能与虐待有关,这可能引发临床怀疑,并导致进一步的检查或干预。通过提高认识,通过医疗服务提供者的教育和增加筛查,早期发现虐待行为可能会防止更严重的伤害和后果。本综述评估了有关儿童虐待的骨科表现的现有文献,希望提高医疗服务提供者的认识。影响:儿童虐待在美国很常见,但往往未被发现。医疗专业人员具有独特的地位,可以评估创伤患者并确定是否存在虐待性损伤的问题。某些骨科损伤可能会引起对虐待的关注,从而引发临床怀疑并进一步检查或干预。