Incidence of fractures among children with burns with concern regarding abuse
Department of Pediatrics
Age Distribution; Bone and Bones; Brain Injuries; Burns; Child Abuse; Contusions; Female; Fractures, Bone; Humans; Incidence; Infant; Male; Multiple Trauma; Retrospective Studies
OBJECTIVE: Consensus recommendations state that a radiographic skeletal survey is mandatory for all children <2 years of age with concern for physical abuse. It has been suggested that patients with burns may represent a special subgroup at lower risk for occult>fractures, compared with other abused children. Our objective was to determine the prevalence of fractures in children referred for subspecialty abuse evaluations because of burns.
METHODS: We performed retrospective analyses of data collected as part of the Using Liver Transaminases to Recognize Abuse (ULTRA) research network. Data were collected for all children <5 years of age who were referred to 19 child protection teams for subspecialty child abuse evaluations over 1 year>(N = 1676). We compared the rate of fractures in children presenting with burns with that in other children evaluated for abuse.
RESULTS: Of 97 children <24 months of age with>burns, 18 (18.6%) were also found to have fractures. Among all 1203 children <24 months of>age, 649 (53.9%) had fractures. Eleven children had multiple fractures, and 12 children had fractures with radiographic evidence of healing. Two children were noted to have classic metaphyseal fractures.
CONCLUSION: The rate of fractures in children who present with burns and concerns regarding physical abuse is sufficient to support the recommendation for routinely performing skeletal surveys for children <2 years of>age.
DOI of Published Version
Pediatrics. 2010 Feb;125(2):e295-9. Epub 2010 Jan 18. Link to article on publisher's site
Degraw M, Hicks RA, Lindberg DM, Using Liver Transaminases to Recognize Abuse (ULTRA) Study Investigators. (2010). Incidence of fractures among children with burns with concern regarding abuse. Child Protection. https://doi.org/10.1542/peds.2009-1478. Retrieved from https://escholarship.umassmed.edu/peds_protection/2