Objectives: This article explores factors associated with referral of children with a femur fracture to a social worker by an orthopedist for suspected child abuse.Methods: This retrospective chart review study included 131 children younger than 5 years who sustained a femur fracture and were hospitalized in a major 495-bed hospital located in the northern-central Israel from 2009 to 2021. Data on children who were referred to a social worker by the treating orthopedist and those who were not were compared.Results: More than half the children studied (58.8%, n = 77) were referred to a social worker by an orthopedist for suspected child abuse. However, only a fifth of these cases were eventually reported to the authorities. Male sex (odds ratio [OR], 2.44), younger age of the child (OR, 0.95), and spiral femur fracture type (OR, 5.30) increased the likelihood of referral. In addition, treatment of the child by an orthopedic specialist (as compared with an orthopedic resident; OR, 3.12) and lengthier professional experience of the treating orthopedist (OR, 1.08) increased the likelihood of referral.Conclusions: Younger male children presenting with a spiral femur fracture have a higher likelihood to be referred to a social worker because of suspected child abuse by treating orthopedic specialists with lengthier professional experience. The findings point to the need to improve the capacity of orthopedic residents to report child abuse.

Purpose This study compared readmissions, survival, and mortality during a 12-month follow-up period of inpatient rehabilitation and home rehabilitation for older persons who had experienced a hip fracture. Methods This work was retrospective cohort research. Between January 1 and December 30, 2019, the medical records of 280 elderly patients who were admitted to a hospital with a hip fracture were analyzed. Of these patients, 74.3% received inpatient rehabilitation, whereas 25.7% received home rehabilitation. Results In terms of readmissions and death, there were no appreciable differences between the inpatient rehabilitation and home rehabilitation groups. The patients in the inpatient rehabilitation group were older; more likely to need assistance with activities of daily living; and were taking, on average, more prescription drugs on a daily basis than those in the home rehabilitation group. Conclusions and Clinical Relevance In conclusion, as better outcomes were expected for the home rehabilitation group, which on average included less complicated patients, our findings suggest that the home rehabilitation pathway may not be a good alternative to the inpatient rehabilitation pathway.