Child Abuse - Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim’s educational animated video teaches about all the signs and symptoms of child abuse.
Child abuse most often occurs under 3 year of age, and if it is not recognized and reported, repeated abuse may occur in 40% of the cases. Death can occur in up to 5%
Risk factors for child abuse:
•First child
•Single parent
•Stepchild
•Disabled child
•Parents were abused
Suspect child abuse if:
•Fracture femur before the walking age ( 1 year) is suspicious. The most common orthopedic injury associated with child abuse is femur fractures.
•Multiple fractures at different stages of healing are seen in a skeletal survey. Stages of healing:
1-hematoma,
2-inflammation
3-soft callus
4-hard callus
5-remodeling .
Callus and periosteal reaction is seen.
•Unwitnessed spiral fractures. Spiral fractures are not a good criteria because most of them are accidental.
Other signs include:
•Multiple soft tissue bruising, skin lesion is the most common, bone fracture is the second most common.
•Corner fracture (metaphyseal fracture especially in the distal femur and proximal tibia). Child abuse should be considered when health care providers see corner fractures in children before they are of walking age.
•Posterior rib fracture from a squeezing injury.
•Distal humerus ; if there is transepiphyseal separation in the humerus suspect child abuse.
Transepiphyseal separation in newborns: The olecranon moves posteriorly, it looks like an elbow dislocation
Transepiphyseal separation in older children: Separation of the distal humerus occurs in younger ages
Abuse occurs more in humerus, tibia and femur (more in the diaphysis)
Management:
•Recognition
•Be non-judgmental
•Obtain skeletal survey
•Obtain bone scan if you suspect abuse and skeletal survey is negative. The most common cause of long term morbidity in an abused child is head injury.
Become a friend on facebook:
/ drebraheim
Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC
Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step