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Published on: August 17, 2017
How common is abuse in Greece? Studying cases with femoral fractures
I Trogan1, N Dessypris, M Moustaki
1University of Rochester School of Medicine, Rochester, NY, USA.
Insights
Undiagnosed child abuse is prevalent in Greece, with femoral fractures in young children often overlooked. The study highlights the need for better detection and intervention by medical professionals and social services.
Area of Science:
- Pediatric Orthopedics
- Child Abuse Forensics
- Public Health
Background:
- Femoral fractures in young children can be indicative of non-accidental trauma.
- Previous literature suggests a significant proportion of such injuries are abuse-related.
- The prevalence of undiagnosed child abuse in Greece, particularly concerning femoral fractures, remains under-examined.
Purpose of the Study:
- To investigate the extent of undiagnosed child abuse in Greece.
- To analyze young children with femoral fractures as a potential indicator of abuse.
- To identify epidemiological risk factors associated with these injuries.
Main Methods:
- Retrospective analysis of 57 pediatric femoral fracture cases (under 6 years) from an injury surveillance database.
- Comparison with 4162 control cases of other orthopedic injuries.
- Evaluation of injury patterns, patient demographics, socioeconomic status, and accident circumstances.
Main Results:
- No cases of femoral fracture in the study cohort were diagnosed or investigated as child abuse, despite literature suggesting one-third are abuse-related.
- Injury patterns, including young male victims, low socioeconomic status, and implausible accident scenarios, were consistent with child abuse.
- Epidemiological risk factors for child abuse were observed in the studied femoral fractures.
Conclusions:
- Child abuse is likely underdiagnosed in Greece, similar to other cultures.
- Femoral fractures in young children present epidemiological risk factors characteristic of child abuse.
- There is an urgent need to improve medical and social service awareness and protocols for identifying and managing child abuse.
Aims:
To examine the extent of undiagnosed child abuse in Greece by studying young children with femoral fractures, which may be associated with abuse.
Methods:
Fifty seven consecutive cases of children under 6 years of age with femoral fracture were identified from the Emergency Department Injury Surveillance System database. Controls were 4162 children with other orthopaedic injuries from the same database.
Results:
Whereas in the literature about one third of femoral injuries among young children are attributed to child abuse, no child in the studied series had been diagnosed or even investigated in this context. Nevertheless, the pattern of occurrence of femoral injuries was compatible with that of child abuse, in that patients were frequently very young boys of low socioeconomic status, and the accident had frequently occurred under poorly identified or implausible conditions at time periods when most family members were crowded at home.
Conclusions:
Epidemiological risk factors for child abuse characterise femoral fractures in young children in Greece. It appears that child abuse is present in this country as in most other cultures. There is a clear need for refocusing medical personnel and hospital social services so that the problem is revealed, quantified, and appropriately dealt with.
