Abstract
Introduction
Non accidental injury is an under diagnosed problem worldwide. It is for this reason that all healthcare workers should be equipped in making the diagnosis and be aware of their obligation according to the Children's Act.
Purpose
The aim of the study was to determine if child abuse is adequately diagnosed at our institution and to identify areas of weakness in our current management protocol.
Methods
Records of all children admitted under the age of 3 years with fractures from January to December 2010 were reviewed. The radiographs were retrospectively classified as likely child abuse or not according to the fracture pattern, by consensus between an orthopaedic surgeon and a radiologist. The x-ray findings were then correlated with the clinical notes, to determine if appropriate management had been instituted in each case. University ethics approval was obtained to undertake the study.
Results
Included in the study are 53 children; it was found that 28 (52%) of these had fractures that could be regarded as being suspicious of a non accidental injury that warranted further investigation. The clinical notes revealed that of the patients at risk, 28 (100%) were referred to a social worker for further investigation and a skeletal survey was only performed in 11 (39%). Only one skeletal survey showed another fracture in a healing stage. Two patients were removed from their primary homes or caregiver.
Conclusion
Our results suggest that non accidental injury according to fracture pattern is under diagnosed and investigated at our institution. Heightened awareness of child abuse is imperative and emphasis must be placed on appropriate investigation and referral where suspicion exists.
NO DISCLOSURES
