Pediatric Nonaccidental Injury

Tenenbaum, Shay; Thein, Ran; Herman, Amir; Chechik, Ofir; Shazar, Nachshon; Zur, Shmulik; Ganel, A

doi:10.1097/bpo.0b013e31827b7b0c

Cited by 9 publications

(6 citation statements)

References 20 publications

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“…Moreover, the lengthier the orthopedist's professional experience, the higher the likelihood of referral, namely, each additional year in the profession increased the likelihood of referral by 8%. These findings contrast with a previous study by Tenenbaum and associates, 8 who found that less-experienced physicians demonstrated more awareness and tendency to further investigate cases with suspected NAT than experienced physicians. Notably, in the present study, no association was found between the treating orthopedist's nationality and the likelihood of referring a child with a femur fracture to a social worker.…”

Section: Discussioncontrasting

confidence: 99%

“…8,17 Thus, one study found that although the American Academy of Orthopedic Surgeons issued clinical practice guidelines recommending NAT evaluation for all patients younger than 36 months, only 48% of this population was indeed evaluated. 17 Moreover, a study by Tenenbaum et al 8 found that although experienced physicians demonstrated higher levels of knowledge than less-experienced physicians, the latter demonstrated more awareness and tendency to further investigate cases with suspected NAT.…”

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confidence: 99%

“…The reasons for this are unclear. It may happen because of the difficulty of differentiating between fractures that do or do not result from abuse, as well as unawareness of clinical practice guidelines regarding criteria for NAT evaluation or compliance with these guidelines 8,17 . Thus, one study found that although the American Academy of Orthopedic Surgeons issued clinical practice guidelines recommending NAT evaluation for all patients younger than 36 months, only 48% of this population was indeed evaluated 17 .…”

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confidence: 99%

“…It may happen because of the difficulty of differentiating between fractures that do or do not result from abuse, as well as unawareness of clinical practice guidelines regarding criteria for NAT evaluation or compliance with these guidelines. 8,17 Thus, one study found that although the American Academy of Orthopedic Surgeons issued clinical practice guidelines recommending NAT evaluation for all patients younger than 36 months, only 48% of this population was indeed evaluated. 17 Moreover, a study by Tenenbaum et al 8 found that although experienced physicians demonstrated higher levels of knowledge than less-experienced physicians, the latter demonstrated more awareness and tendency to further investigate cases with suspected NAT.…”

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confidence: 99%

“…Moreover, orthopedic surgeons may be the only physicians encountered by an abused child; hence, orthopedic surgeons have an extremely important role. This role includes recognition, treatment, and appropriate report of suspected child abuse 8 . Most children presenting with fractures are not victims of physical abuse; however, it is vital that NAT remains part of the differential diagnosis for all pediatric orthopedic patients 6 …”

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confidence: 99%

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Factors Associated With Referral of Children With a Femur Fracture to a Social Worker by an Orthopedist for Suspected Child Abuse

Yonai¹,

Natan

Finkel³

et al. 2022

Pediatr Emer Care

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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.

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Section: Discussioncontrasting

confidence: 99%

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