ArticleChild abuse & neglect2023
Skeletal survey yields in low vs. high risk pediatric patients with skull fractures.
Article in Child abuse & neglect, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Factors Associated With Child Protective Services Referrals in Young Children With Isolated Skull Fractures.Academic pediatrics · 2026Article
- Testing for bleeding disorders in child abuse: AAP recommendation adherence and testing results.Child abuse & neglect · 2025Article
- Quantitative morphological analysis framework of infant cranial sutures and fontanelles based on CT images.Journal of anatomy · 2024Article
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Authors and funding
13 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundTo assess for occult fractures, physicians often opt to obtain skeletal surveys (SS) in young, acutely head-injured patients who present with skull fractures. Data informing optimal decision management are lacking.
objectiveTo determine the positive yields of radiologic SS in young patients with skull fractures presumed to be at low vs. high risk for abuse. PARTICIPANTS AND
setting476 acutely head injured, skull-fractured patients <3 years hospitalized for intensive care across 18 sites between February 2011 and March 2021.
methodsWe conducted a retrospective, secondary analysis of the combined, prospective Pediatric Brain Injury Research Network (PediBIRN) data set.
results204 (43 %) of 476 patients had simple, linear, parietal skull fractures. 272 (57 %) had more complex skull fracture(s). Only 315 (66 %) of 476 patients underwent SS, including 102 (32 %) patients presumed to be at low risk for abuse (patients who presented with a consistent history of accidental trauma; intracranial injuries no deeper than the cortical brain; and no respiratory compromise, alteration or loss of consciousness, seizures, or skin injuries suspicious for abuse). Only one of 102 low risk patients revealed findings indicative of abuse. In two other low risk patients, SS helped to confirm metabolic bone disease.
conclusionsLess than 1 % of low risk patients under three years of age who presented with simple or complex skull fracture(s) revealed other abusive fractures. Our results could inform efforts to reduce unnecessary skeletal surveys.
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