Does bruising help determine which fractures are caused by abuse?

Thomas J. Valvano, Helen J. Binns, Emalee G. Flaherty, Dan E. Leonhardt

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

To determine whether the presence or absence of bruising can be used to differentiate between abusive and nonabusive fractures, a retrospective study was conducted of patients with acute fractures referred to a child abuse team. A bruise and fracture were considered associated if both occurred on the same body site. Chart summaries, excluding information on bruising, were reviewed by 2 abuse experts to assign cause of injury. Of the 150 participants, fractures of 93 (62%) were categorized as abusive and 57 (38%) as nonabusive. Bruising associated with a fracture was found for 26% of abused and 25% of nonabused children. Most children (61%) had no bruises anywhere on the body, and this did not differ significantly by cause of injury. The sensitivity of a bruise associated with a fracture to predict abuse was only 26%. The presence or absence of bruising was not useful to differentiate between abusive and nonabusive fractures.

Original languageEnglish (US)
Pages (from-to)376-381
Number of pages6
JournalChild Maltreatment
Volume14
Issue number4
DOIs
StatePublished - Nov 1 2009

Keywords

  • Abuse
  • Bruise
  • Fracture

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology

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