Child abuse

Revisión del 22:43 14 jun 2014 de SRafael (discusión | contribs.) (Created page with "==Background== *Infant and children with disabilities are at higher risk *In >80% of cases, the parent or primary guardian is the abuser *Risk factors **Domestic violence **Ma...")
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Background

  • Infant and children with disabilities are at higher risk
  • In >80% of cases, the parent or primary guardian is the abuser
  • Risk factors
    • Domestic violence
    • Maternal depression
    • Drug and alcohol abuse
    • Premature birth
    • Unrealistic expectations for the child

Clinical Features

  • History given is inconsistent with the mechanism of injury
  • Bruises, ecchymosis, and soft-tissue injuries on the face, cheeks, back, neck of if the child is not cruising yet
  • Bruises in clusters or patterned marks
  • Fractures highly suspicious of abuse:
    • Rib fractures, especially posterior
    • Metaphyseal or "bucket handle" fractures
    • Scapular fractures
    • Spinous process fractures
    • Sternal fractures
  • Fractures moderately suspicious of abuse:
    • Long-bone transverse or spiral fracture of the diaphysis of the femur, humerus, tibia
    • Multiple bilateral fractures
    • Different stages of healing with multiple fractures
    • Epiphyseal separations
    • Vertebral body separation
    • Complex skull fractures
    • Pelvis fractures

Workup

Management

Disposition

See Also

Sources

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