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Pelvic Fractures in Infants as a Sign of Physical Abuse

NCJ Number
208773
Journal
Child Abuse & Neglect: The International Journal Volume: 26 Issue: 5 Dated: May 2002 Pages: 475-480
Author(s)
Suzanne P. Starling; Richard M. Heller; Carole Jenny
Date Published
May 2002
Length
6 pages
Annotation
After describing pelvic fractures in two abused male infants, this article reviews the relevant literature to determine whether pelvic fractures in infants raise suspicions of abuse.
Abstract
Pelvic fractures in children are seen most often in the setting of major trauma. Case reports of inflicted pelvic trauma in children are uncommon and have been found exclusively in the radiological and surgical literature. In one of the cases presented, the child exhibited several common symptoms of child abuse, i.e., multiple fractures of various ages, multiple skin and soft tissue injuries with no explanation, and a delay in the diagnosis of child abuse despite several interactions with physicians. The second case revealed the common presentation of occult inflicted injury discovered on routine x-rays taken for an unrelated medical complaint. The diagnosis of child physical abuse based on multiple unexplained fractures in an infant is clear in these cases; however, both children also exhibited pelvic fractures not commonly described in the literature. The literature suggests that a significant degree of physical trauma is required to inflict pelvic fractures. Also, the majority of battered children with lower extremity injuries do not suffer pelvic fracture. The authors argue that pelvic fractures in children, in the absence of serious, well-documented accidents, should be considered highly suspicious for child physical abuse. 1 table and 18 references