Child Abuse Flashcards

Flashcards about Child Abuse

Metaphyseal fractures

Fractures commonly occur around epiphysis & metaphysis of growing bone.

Corner's fracture

Separation of corners of long bones.

Bucket handle fracture

Epiphysis can separate from the metaphysis as an arc.

Mechanism of Metaphyseal fractures

Traction & twisting of limbs, or Limb swinging during shaking a baby

Corner fracture

Typical corner fracture very specific for non accidental trauma.

Corner fracture

Avulsion of metaphyseal tips.

Spiral fracture

A long bone fracture due to twisting strain which is uncommon in accidental fractures due to simple falls.

Callus in diaphyseal fractures

Generally forms no earlier than 5 days after a fracture, but will usually form by 14 days.

Subperiosteal calcification in old hematoma

Bleeding rapidly calcifies (7- 14 day) giving a characteristic radiological picture of a bony shell extending along the shaft (callus).

Rib fractures Mechanism

Commonly due to adult squeezing tightly of the chest during violent shaking or direct trauma to the ribs.

Rib fractures

Posterior & lateral rib fractures are highly specific for abuse.

Old (healed) rib damage

Has a specific radiological findings (string of beads- appearance).

Resuscitation-induced fractures

Usually anterior in location at the sterno-chondral junction and midclavicular line.

Head injuries

The most frequent cause of death in child abuse.

Fissure fracture

Commonest site: temporal or parietal bone.

Multiple fissure fractures

Marker of significant trauma to the head and Common in fatal cases of physical child abuse

"Growing up" skull fractures

Commonly associated with abuse and Running through sutures

Intracranial injuries

Most frequent cause of death in child abuse.

Subdural hematoma Mechanism

May arise from direct impact with or without skull fractures or from vigorous shaking (Whip lash).

Other intracranial injuries

Extradural hemorrhage & Subarachnoid hemorrhage are uncommon in child abuse.

Ocular injuries

Black eye, scleral and conjunctival hemorrhages

Retinal & vitreous hemorrhage Mechanism

Violent shaking of the head or Direct impact upon the head.

Ear injuries

The pinna may be bruised or even lacerated usually by an open handed slap.

Oral injuries

Lip bruises or abrasions

Torn frenulum

It is a characteristic lesion of physical child abuse

Torn frenulum Mechanism

A tangential blow across the mouth or an object being rammed forcibly into the mouth between lip and gum

Rupture abdominal viscus

The 2nd most common cause of death in child abuse after head injury.

Small intestine injuries

Duodenum or jejunum being the most frequent sites of damage.

Mechanism of Small intestine injuries

blow to the thin anterior abdominal wall In infants, can sandwich the duodenum and jejunum between the impact and the lumbar spine, crushing or even cleanly transecting the gut.

Liver injury

Commonest is deep tear in eitherlobes and rarely actual detachment of hepatic tissues.