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Fracture ratio can help assess nonaccidental trauma in pediatric patients
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Use of the fracture ratio can help determine fracture morphology and be used to assess a pediatric patient with suspected nonaccidental trauma, according to study results.
Researchers calculated anteroposterior and lateral fracture ratios for 95 patients who were 3 years of age or younger and had a closed, isolated femoral shaft fracture between 2005 and 2013. The researchers reviewed the presence or absence of a Child Protective Services referral and institutional Child Assessment Program evaluations. Child Protective Services or an on-site Child Assessment Program team deemed nonaccidental trauma to be present, absent or indeterminate. The researchers also used the Modified Maltreatment Classification System to further evaluate and quantify the likelihood of nonaccidental trauma.
Results showed 54% of patients had either a Child Protective Services or a Child Assessment Program consultation due to suspected nonaccidental trauma. Overall, the researchers found 25% of the patients had nonaccidental trauma and 14% had indeterminate trauma as determined by Child Protective Services or Child Assessment Program investigations.
A positive Modified Maltreatment Classification System score for physical abuse was found among all patients identified with nonaccidental and indeterminate trauma, according to investigation results.
Additionally, the researchers found significantly decreased mean anteroposterior fracture ratios among patients identified with nonaccidental trauma vs. patients who had confirmed accidental trauma.
Disclosures: The authors report no relevant financial disclosures.
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