Forensic Aspects of Pediatric Fractures (eBook)

Foreword I 6
Foreword II 7
Contents 9
General Aspects of Fractures in Child Abuse 15
1.1 Introduction 15
1.2 Incidence of Fractures in Children 16
1.3 Difference Between Fractures in Children and Adults 17
1.4 Fractures: Differential Diagnosis 18
1.5 Fractures in Child Abuse 21
1.6 The Role of the Radiologist When Child Abuse Is Suspected 25
1.7 Ethical Dilemmas in Suspicion of Child Abuse 26
References 26
Head 28
2.1 Introduction 28
2.2 Signs, Symptoms and Complications 28
2.3 Biomechanical Aspects of Fractures of the Cranium 28
2.4 Types of Skull Fracture 31
2.5 Skull Fractures and Intracranial Injury 35
2.6 Skull Fractures: Differential Diagnosis 38
2.7 Growing Fractures of the Skull 49
2.8 The Dating of Skull Fractures 52
2.9 Basilar Fractures 53
2.10 Facial Fractures and Dental Damage 53
References 56
Ribs 61
3.1 Introduction 61
3.2 Signs, Symptoms and Complications 61
3.3 Biomechanical Aspects of Rib Fractures 62
3.4 Rib Fractures and Child Abuse 65
3.5 Rib Fractures: Differential Diagnosis 70
References 77
Clavicles, Scapulas, Sternum, Vertebrae and Pelvis 79
4.1 Clavicles 79
4.2 Sternum 81
4.3 Scapula Fractures 4.3.1 Introduction 82
4.4 Fractures of the Vertebrae 83
4.5 Fractures of the Pelvis 86
References 88
The Extremities 91
5.1 Introduction 91
5.2 Anatomy and Physiology 91
5.3 Shaft Fractures 92
5.4 Injuries to Metaphysis and Epiphysis 94
5.5 Humerus 99
5.6 Radius and Ulna 103
5.7 Femur 106
5.8 Tibia and Fibula 110
5.9 Shaft Fractures of the Lower Extremities 112
5.10 Hands and Feet 113
5.11 Subperiosteal Haemorrhages/ Calcifications 113
5.12 Growth-Retardation Lines 113
References 116
Accidental Trauma 119
6.1 Introduction 119
6.2 Fractures Resulting from Birth Trauma 119
6.3 Accidental Fractures 121
6.4 Short-Distance Fall 124
6.5 Fall with a Baby Walker 127
6.6 Baby Bouncer-Related Injuries 129
6.7 Fall from Bunk Bed 129
6.8 Fall from a Perambulator 132
6.9 Fall from a High Chair 133
6.10 Fall from a Staircase 134
6.11 Fall from a Shopping Trolley 135
6.12 Fall from a Trampoline 136
6.13 Fall from a Considerable Height 137
6.14 Fractures Resulting from Daily Care and Medical Procedures 138
6.15 Sports Fractures 140
References 141
Normal Variants, Congenital and Acquired Disorders 144
7.1 Introduction 144
7.2 Normal Variants 144
7.3 Osteogenesis Imperfecta 144
7.4 Rickets 151
7.5 Syndromes and Congenital disorders 158
7.6 Skeletal Dysplasias 162
7.7 Metabolic Disorders 163
7.8 Infectious Diseases 166
7.9 Oncological Diseases 168
7.10 Medication-Related Abnormalities 171
7.11 Other Disorders 175
7.12 ‘Temporary Brittle-Bone Disease’? 177
References 178
Radiology in Suspected Child Abuse 182
8.1 Introduction 182
8.2 Conventional Radiology 182
8.3 Bone Scintigraphy 190
8.4 Computed Tomography and Magnetic Resonance Imaging 191
8.5 Postmortem Imaging 192
References 198
Fracture Dating 200
9.1 Introduction 200
9.2 Anamnestic and Clinical Manifestations 201
9.3 Radiological Characteristics 201
9.4 Histological Fracture Dating of Fresh and Dried Bone Tissue 205
References 211
Index 215