Child abuse: review of the literature

Abstract

Non-accidental injuries in children are an important cause of morbidity and mortality in this population. Fractures are the second most common clinical manifestation of child abuse. The fracture of the femur is associated in more than 60% of child abuse in children younger than 3 years. The objective was to review the literature on child abuse in the major databases and report a rare case of bilateral subtrochanteric femur fractures associated with unilaterall humeral fracture in a 28-day newborn. The orthopedic surgeon is often the first physician to evaluate these children, so a high degree of suspicion, and a physical examination and a detailed clinical history is mandatory when evaluating a newborn with musculoskeletal injuries.

Keywords: Child abuse; Femoral fractures; Humeral fracture.

Fig. 1

Radiograph at the time of admission.

Fig. 2

Humeral fracture at the time of admission.

Fig. 3

Radiograph of the arm at the age of three weeks.

Fig. 4

Radiograph of the femurs at the age of three weeks.

Fig. 5

Radiograph at the age of two months.

Fig. 6

Radiograph at the age of four months.

Fig. 7

Radiograph of the proximal femur at the age of six months.

Fig. 8

Radiograph of the humerus at the age of six months.

Fig. 9

Photograph at the age of six months, showing absence of anisomelia or significant deformities.