Kindesmisshandlung aus pädiatrischer Sicht

Meyer, Sascha; Poryo, Martin; Clasen, Oriana; Schlote, Julia; Schmidt, Péter; Schöndorf, Dominik; Lehmann-Kannt, S.; Gortner, Ludwig

doi:10.1007/s00117-016-0103-0

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…All patients with suspected child abuse showed typical injuries around the head and uncommon fractures for the age. Typical characteristics described in the literature include patient age less than 1 and head injuries and strangulation marks that may indicate possible child abuse [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

Cintean

Eickhoff

Zieger

et al. 2022

Eur J Trauma Emerg Surg

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Background Pediatric traumas are common and remain a unique challenge for trauma surgeons. Demographic data provide a crucial source of information to better understand mechanisms and patterns of injury. The aim of this study was to provide this information to improve treatment strategies of potentially preventable morbidity and mortality in children. Material and methods A retrospective review of every pediatric trauma treated in the emergency department (ED) between 2015 and 2019 was performed. Inclusion criteria were the age between 0 and 14 years and admission to the ED after trauma. Demographic data, time of presentation, mechanism of injury and pattern of injury, treatment, and outcome were analyzed. Different injury patterns were assessed in relation to age group, sex, mechanism of injury and treatment. Results A total of 12,508 patients were included in this study. All patients were stratified into five age groups: babies under the age of 1 (8.8%), toddlers between 1 and 3 (16.8%), preschool children between 4 and 6 (19.3%), young school children between 7 and 10 (27.1%), and young adolescents between 11 and 14 (27.9%). The predominant sex in all age groups was male. 47.7% of patients were admitted between 4 and 10 pm; 14.8% of the patients arrived between 10 pm and 8 am. Peak months of admissions were May to July. Overall, 2703 fractures, 2924 lacerations and superficial tissue injury, 5151 bruises, 320 joint dislocations, 1284 distortions, 76 burns, and 50 other injuries were treated. Most common mechanisms for fractures were leisure activities, falls, and sports-related activities. Forearm fractures were the most common fractures (39.5%) followed by humerus fractures (14%) and fractures of the hand (12.5%). A total of 700 patients with fractures (25.9%) needed surgery. 8.8% of all patients were hospitalized for at least one day. 4 patients died in the hospital (0.03%). Conclusion Despite of higher risk, severe injuries in children are rare. Minor injuries and single fractures are common. Treatment should be managed in specialized centers to ensure an interdisciplinary care and fast recovery. Peak times in the late afternoon and evening and summer months should be taken into consideration of personnel planning.

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Section: Discussionmentioning

confidence: 99%

Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

Cintean

Eickhoff

Zieger

et al. 2022

Eur J Trauma Emerg Surg

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“…This offer must be extended to families with higher risk of child maltreatment, such as crying babies, infants with disabilities, socially disadvantaged parents, multiple (>3) children and single parents. 33 During home visits, midwives gain a deep insight into the family structure. The tasks of midwives must be expanded, with a focus on passing on knowledge, including AHT prevention.…”

Section: Discussionmentioning

confidence: 99%

“…Midwife support during pregnancy and after birth is covered by national health insurance, such as midwife advice in the 18th–22nd weeks of pregnancy and one home visit daily from the 1st to the 5th day after birth, while additional home visits or consultation hours in the midwife's office are limited to mothers after caesarean section, premature birth or multiple births. This offer must be extended to families with higher risk of child maltreatment, such as crying babies, infants with disabilities, socially disadvantaged parents, multiple (>3) children and single parents 33 . During home visits, midwives gain a deep insight into the family structure.…”

Section: Discussionmentioning

confidence: 99%

Abusive head trauma and crying infant–Public awareness of newborn and infant trauma

Arneitz,

Schmitz,

Szilagyi

et al. 2024

Acta Paediatrica

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AimCrying seems to be a common trigger for abusive head trauma (AHT), which is the leading cause of fatalities from physical abuse in infants. Our objective was to evaluate knowledge of AHT, crying infants and correct behavioural measures in a general population.MethodsAn online questionnaire (LimeSurvey) was created to assess the risk of shaking. The online survey contained a total of 41 questions, including a demonstration of a previously recorded video in which an infant doll is shaken.ResultsA total of 319 people, 245 of them (76.8%) with own children, participated in the study. Almost all respondents (98.4%) were aware of serious injuries due to shaking, even to the point of death (98.1%). Most participants (97.5%) had heard the term ‘shaking trauma’ prior but did not receive any professional information, neither before nor after birth (85.2% or 86%), or during follow‐up examinations (88.5%). The majority of the participants (95%) considered that useful coping strategies in infant crying were inappropriate.ConclusionThe consequences of shaking an infant were common knowledge in a normal population, whereas there was a knowledge gap regarding the management of excessive crying infants. Prevention programmes should mainly focus on male caregivers during postnatal care.

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“…However, suspicion of child abuse should be kept in mind. Femoral shaft fractures are reported to be rare after intentional trauma with typical injuries being meta- and epiphyseal fractures as well as trauma of the torso and head [ 8 , 9 , 30 , 31 ]. Management of femoral shaft fractures in children is affected by a wide number of variables including age and weight of the patient, fracture pattern and associated injuries [ 1 , 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

ESIN in femur fractures in children under 3: is it safe?

Cintean

Eickhoff

Pankratz

et al. 2022

Eur J Trauma Emerg Surg

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Background Pediatric femur fractures are a major trauma in children. Different treatment algorithms have been developed but indications for surgical treatment, especially in very young patients, are still controversial. Literature recommends surgical stabilization with elastic-stable intramedullary nailing (ESIN) starting at the age of 3 and non-operative treatment in younger patients. This study sought to present the outcome of patients younger than 3 years of age treated with ESIN for femur fractures. Materials and methods Inclusion criteria were patients younger than 3 treated with ESIN in femur fractures. Patient demographics, fracture characteristics, mechanism of injury, outcomes and complications were recorded using charts and X-rays. Primary outcome measures were time to mobility, fracture consolidation and surgical-related complications. Results Between 2010 and 2020, 159 patients were treated with ESIN in femur fractures in our institution. A total of 30 patients met the criteria. The mean age was 2.1 ± 0.7 years (13 months–2.9 years). Most common mechanism was fall from standing height (60%). Other mechanisms were motor vehicle accidents as a pedestrian (10%) or as a passenger (10%) as well as direct blow trauma (20%). Femoral shaft fracture was the most common injury (80%). 5 subtrochanteric and one distal metaphyseal femur fractures were found. Mean length of stay was 2.0 ± 1.3 days. Radiographic controls were performed on day 1, 14 and 6 weeks after surgery if not otherwise specified or if complications occurred. 4.6 ± 1.2 (n 2–7) X-rays were performed on average after surgery. First radiographic consolidation signs were seen after 2.4 ± 0.6 weeks. Only one child showed surgical-related complication with a leg length discrepancy of 1 cm. In 10% of the patients, shortening after surgery of 1.7 ± 1.4 mm (0.3–3.1 mm) occurred. One child initially treated with traction therapy showed skin irritations and was operated with ESIN. No non-union or ESIN-related complications were found. Mean follow-up was 5.1 ± 4.4 months (4–24 months). First independent mobilization was seen at an average of 3.4 ± 1.1 weeks (2–6 weeks) after surgery. Implant removal was performed after 3.2 ± 1.3 months (2–8 months). No refracture after implant removal occurred. Conclusion Early results with ESIN show a reasonable and safe treatment option for femur fractures in toddlers and young children under the age of 3 with easy postoperative care, fast fracture union and early independent mobilization.

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Kindesmisshandlung aus pädiatrischer Sicht

Abstract: In addition to providing acute medical help, longer-term, multidisciplinary interventions have to be put in place in cases of child abuse. This article summarizes the most important facts pertinent to this subject.

Cited by 5 publications

References 26 publications

Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

Abusive head trauma and crying infant–Public awareness of newborn and infant trauma

ESIN in femur fractures in children under 3: is it safe?

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