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Orthopedic manifestations of child abuse
John D Milner1, Davis A Hartnett2, Steven F DeFroda2
1Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, 593 Eddy Street, Providence, RI, USA. john_milner@brown.edu.
Insights
Child abuse is prevalent but often missed. Recognizing orthopedic injuries in children can help medical providers detect abuse early, preventing severe consequences and improving outcomes.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Forensic Medicine
Background:
- Child abuse is a significant public health issue in the United States, frequently going undetected.
- Children with a history of abuse face increased risks of chronic health conditions.
- Medical providers play a crucial role in identifying abuse and are mandated reporters.
Purpose of the Study:
- To review current literature on the orthopedic manifestations of child abuse.
- To enhance medical provider awareness of potential indicators of abuse.
- To emphasize the importance of early detection in preventing severe injuries.
Main Methods:
- Literature review of studies on orthopedic injuries and child abuse.
- Analysis of how specific orthopedic injuries can raise suspicion for abuse.
- Evaluation of the role of medical providers in screening and reporting.
Main Results:
- Certain orthopedic injuries are strongly associated with abusive trauma.
- Clinical suspicion of abuse can be triggered by specific injury patterns.
- Early identification through history and screening aids in intervention.
Conclusions:
- Increased medical provider awareness of orthopedic signs of child abuse is critical.
- Education and screening protocols can lead to earlier detection of child abuse.
- Prompt identification and intervention can mitigate long-term health consequences for abused children.
Abstract:
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.
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