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Identification of Potential Abuse in Young Children with a Hand Fracture
Merav Ben Natan1,2, David Maman3,4,5, Yaron Berkovich3,4,5
1Hillel Yaffe Academic School of Nursing, P.O.B. 169, Hadera, 38100 Israel.
Insights
Child abuse in young children with hand fractures is linked to Arab nationality, previous fractures, and hospitalizations. Healthcare providers should recognize these risk factors for early identification and protection.
Area of Science:
- Pediatric Emergency Medicine
- Child Abuse Forensics
- Public Health
Background:
- Child abuse identification in young children, particularly with hand fractures, poses diagnostic challenges for healthcare professionals.
- Early recognition is crucial for intervention and safeguarding vulnerable children.
Purpose of the Study:
- To investigate socio-demographic and medical factors associated with child abuse in children under five presenting with hand fractures.
- To identify risk factors that can aid healthcare providers in detecting child abuse in this population.
Main Methods:
- Retrospective analysis of 828 children under five with hand fractures from 2018-2023.
- Examination of factors including nationality, prior fracture history, and recent hospitalizations.
- Logistic regression analysis to determine statistically significant associations with child abuse.
Main Results:
- 3.6% (30 children) were identified as victims of abuse.
- Significant risk factors for abuse included Arab nationality (OR 2.4), prior fracture history (OR 1.9), and recent hospitalization (OR 3.1).
- Abused children had more prior fractures and hospitalizations; fathers were the alleged perpetrators in documented abuse cases.
Conclusions:
- Healthcare providers must be vigilant in identifying potential child abuse, especially with recurrent injuries and frequent hospital visits.
- Understanding identified risk factors can improve early detection and protection of children at risk.
- Further research is recommended to enhance protective measures and deepen understanding of child abuse identification factors.
Purpose:
Identifying child abuse in young children, especially through hand fractures, presents a significant challenge for healthcare providers. This study aimed to explore the socio-demographic and medical characteristics associated with child abuse in children under five who presented with hand fractures at a pediatric emergency department in north-central Israel from 2018 to 2023.
Methods:
This retrospective study analyzed data from 828 children who presented with hand fractures. Key factors, such as nationality, history of previous fractures, and recent hospitalizations, were examined for their association with child abuse. Statistical analyses, including logistic regression, were performed to determine associations and significance.
Results:
The study identified 30 (3.6%) victims of abuse among the cohort. Significant factors associated with a higher likelihood of abuse included Arab nationality (OR 2.4; 95% CI 1.01-5.93), prior fracture history (OR 1.9; 95% CI 1.20-2.99), and hospitalization within the past year (OR 3.1; 95% CI 1.31-7.46), all with p-values < 0.01. Victims of abuse had more previous fractures (M = 0.93) and more hospitalizations in the previous year (M = 1.13) compared to non-victims. In the reviewed cases classified as abuse, documentation indicated the father as the alleged perpetrator in each instance.
Conclusions:
These findings highlight the critical role of healthcare providers in recognizing and reporting potential child abuse, particularly in cases of recurrent injuries and frequent hospital visits. Understanding these risk factors can help in early identification and protection of at-risk children. Further research is needed to enhance protective measures and gain deeper insights into the factors influencing the identification of child abuse.
