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Plausibility Model Femur Fractures Resulting From Stair Falls Among Children: An Injury

Published on Jan 1, 2013
Eva Vogeley5
Estimated H-index: 5
,
Morey S. Moreland18
Estimated H-index: 18
+ 5 AuthorsFernando Aguel5
Estimated H-index: 5
Abstract
ABSTRACT. Background. Stair falls are commonamong young children and are also common false histo-ries in cases of child abuse. When a child presents with afemur fracture and a stair-fall history, a judgment ofplausibility must be made. A lack of objective injury andbiomechanical data makes plausibility determinationmore difficult. Our objective was to characterize keyfeatures associated with femur fractures from reportedstair falls, to develop a model for assessing injury plau-sibility (IP). Methods. Children 2 to 36 months of age who pre-sented with a femur fracture from a reported stair fallwere studied prospectively. Detailed history recording,examinations, fracture characterization, and injury sceneanalyses were conducted, and biomechanical measuresassociated with injury prediction were calculated. Withour proposed IP model, all cases were then scored for thedetail of history, biomechanical compatibility of fracturemorphologic features, time to seeking care, and presenceof other injuries.
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#1Ev Vogeley (University of Pittsburgh)H-Index: 4
#2Mary Clyde Pierce (University of Pittsburgh)H-Index: 21
Last. Gina Bertocci (University of Pittsburgh)H-Index: 19
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Bruising is very common in children. Examination of bruising can guide the clinician in ordering radiographic imaging studies of children who have suffered trauma. Additionally, bruising in infants and patterns of bruising that do not match the injury scenario offered by caretakers can raise the suspicion of abuse. This article reports preliminary experience with Wood lamp enhancement of faint bruises and visualization of bruises that are not visible. It describes the method for digital photogra...
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#1Mini N. PathriaH-Index: 1
Diagnostic imaging plays an important role in the detection, management, and follow-up of skeletal and soft tissue injuries. The use of routine radiography to identify fractures constituted one of the earliest applications of this technique. Fractures represent incomplete or complete breaks in the continuity of bones, which may result from a single episode of excessive stress applied to normal bone, multiple episodes of excessive stress applied to normal bone, or normal or excessive stress appli...
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#1Mark A. GomezH-Index: 17
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Bone is a dynamic, living tissue. As a material as well as a structure, it is in a constant state of flux. Consequently, the ability of bone to resist an applied load before failure or fracture is dependent on multiple factors. Age, disease, hormone levels, too little load, too much load, or even the direction in which a load is applied can all influence the biomechanical properties of bone. In particular, the potential of the bone to resist fracture is affected by these physiologic and mechanic...
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#1Gina Bertocci (University of Pittsburgh)H-Index: 19
#2Mary Clyde Pierce (University of Pittsburgh)H-Index: 21
Last. Fernando Aguel (University of Pittsburgh)H-Index: 5
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Last. Nancy Lee LelandH-Index: 1
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One hundred thirty-nine children younger than 4 years were identified retrospectively from the period of 1993 through 1997 to have an isolated fracture of the shaft of one or both femurs. Abuse was classified as group A (definite, likely, or questionable abuse) or group B (unknown cause, questionable accident, likely accident, or definite accident). The average age of the children was 2.3 ± 1.1 years. Thirteen children, 9% of the total group, average age of 1.1 ± 1.0 years, were likely to have b...
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A retrospective review of 207 patients younger than 6 years of age who sustained nonpathologic diaphyseal femur fractures was done, which emphasized the characteristics of accidental versus nonaccidental injury. There were 214 fractures in 123 boys and 83 girls (the gender of one patient was unknown). The average age of the patients was 2.73 years. Mechanisms of injury were pedestrian struck by a car (62 patients), falls (92 patients), and motor vehicle accidents (10 patients). Nineteen patients...
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