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Causative factors responsible for femoral fractures in infants and young children
Insights
Childhood femoral fractures in young children are frequently caused by abuse. Infants under one year old are particularly vulnerable, with abuse being the primary cause of their fractures.
Area of Science:
- Pediatric Orthopedics
- Child Abuse Research
- Trauma Surgery
Background:
- Femoral fractures are a significant injury in young children.
- Determining the causative factor is crucial for appropriate medical and legal intervention.
- Child abuse is a known cause of fractures in this age group.
Purpose of the Study:
- To identify the causative factors of femoral fractures in children 5 years old or younger.
- To assess the incidence of abuse as a cause of these fractures.
- To provide guidance for orthopedic surgeons in evaluating potential abuse.
Main Methods:
- Retrospective review of 74 pediatric femoral fracture cases.
- Analysis of patient demographics and injury circumstances.
- Categorization of fractures by suspected or confirmed etiology.
Main Results:
- Nearly half (34/74) of femoral fractures were attributed to abuse.
- Abuse was the cause in most fractures (17/26) among infants under 1 year.
- Automobile-pedestrian accidents accounted for seven fractures in children aged 2 years and older.
Conclusions:
- Abuse is a leading cause of femoral fractures in young children, especially infants.
- Orthopedic clinicians should maintain a high index of suspicion for abuse in these cases.
- Accurate history, diligent record-keeping, and awareness of abuse incidence aid in diagnosis and appropriate family management.
Abstract:
The causative factor responsible for producing a femoral fracture was determined in 74 children 5 years of age or younger admitted to Oklahoma Children's Memorial Hospital over a 5-year period. Almost one-half of the fractures (34/74) were sustained as a result of suspected or confirmed abuse; most (17/26) of the fractures in infants less than 1 year of age were a result of abuse. Seven automobile-pedestrian accidents were causative in children 2 years or older. An accurate history, good record keeping, common sense, and awareness of the incidence of abuse will assist the orthopedist in recognizing abuse when it is likely, and sparing the family when it is not.