Sixteen Fractures in a Seven-Month-Old Child Caused by Nonaccidental Trauma

Abstract

Definition of physical child abuse is used to refer to a casualty injured by the caregiver. Health-care professionals providing medical care are responsible for detecting and reporting child abuse. A 7-month-old pediatric patient was referred to us from an outer center with the diagnosis of multiple fractures (14 different bones in 16 different anatomical regions). Skeletal pathologies were evaluated after exclusion of head and abdomen injuries in the emergency department. This child with fractures in 16 different anatomical regions of 14 different bones in her body is alive and does not have an intracranial injury. The number of fractures was too high to be explained even by major trauma. If child abuse is suspected, relevant authorities should be notified immediately. Medical records must be meticulously done as they can contribute to the possible court process. Our case, which contains almost all of the history and physical examination and risk factors of typical child abuse, is instructive enough to guide any health-care professional who may encounter this issue. The threshold in deciding on reporting of child abuse should be low. Every suspicious case should be reported in order to prevent repetitive abuse.

Keywords

• nonaccidental trauma
• physical child abuse
• pediatric trauma
• pediatric multifracture