Universität zu Köln

Feld, Katharina ORCID: 0000-0003-2699-2741, Ricken, Tim, Feld, Dustin, Helmus, Janine, Hahnemann, Maria, Schenkl, Sebastian, Muggenthaler, Holger, Pfeiffer, Heidi, Banaschak, Sibylle, Karger, Bernd and Wittschieber, Daniel (2022). Fractures and skin lesions in pediatric abusive head trauma: a forensic multi-center study. Int. J. Legal Med., 136 (2). S. 591 - 602. NEW YORK: SPRINGER. ISSN 1437-1596

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Abstract

Abusive head trauma (AHT) and its most common variant, the shaken baby syndrome (SBS), are predominantly characterized by central nervous system-associated lesions. Relatively little data are available on the value of skeletal and skin injuries for the diagnosis of SBS or AHT. Thus, the present study retrospectively investigated 72 cases of living children diagnosed with the explicit diagnosis of SBS during medico-legal examinations at three German university institutes of legal medicine. The risk of circular reasoning was reduced by the presence of 15 cases with confession by perpetrators. Accordingly, the comparison with the 57 non-confession cases yielded no significant differences. Skeletal survey by conventional projection radiography, often incomplete, was found to be performed in 78% of the cases only. Fractures were found in 32% of the cases. The skull (43%) and ribs (48%) were affected most frequently; only 8% of the cases showed classic metaphyseal lesions. In 48% of the cases, healing fractures were present. Skin lesions (hematomas and abrasions) were found in 53% of the cases with the face (76%), scalp (26%), and trunk (50%) being the major sites. In 48% of the cases, healing skin lesions were observed. Nearly 80% of the cases with fractures also showed skin lesions. The data prove that SBS is frequently accompanied by other forms of physical abuse. Therefore, skeletal survey is indispensable and should always be done completely and according to existing imaging guidelines if child abuse is suspected.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Feld, Katharina UNSPECIFIED orcid.org/0000-0003-2699-2741 UNSPECIFIED Ricken, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Feld, Dustin UNSPECIFIED UNSPECIFIED UNSPECIFIED Helmus, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahnemann, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Schenkl, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Muggenthaler, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeiffer, Heidi UNSPECIFIED UNSPECIFIED UNSPECIFIED Banaschak, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED Karger, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittschieber, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-590601
DOI:	10.1007/s00414-021-02751-4
Journal or Publication Title:	Int. J. Legal Med.
Volume:	136
Number:	2
Page Range:	S. 591 - 602
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1437-1596
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SHAKEN BABY SYNDROME; BRAIN-INJURY; YOUNG-CHILDREN; BRUISING CHARACTERISTICS; INFANTS; HEMORRHAGE; PREVALENCE; HISTORY; STATES; RISK Multiple languages Medicine, Legal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59060