Inflicted Skeletal Trauma: The Relationship of Perpetrators to Their Victims

• NCJ Number: 220882
• Journal: Child Abuse & Neglect; The International Journal Volume: 31 Issue: 9 Dated: September 2007 Pages: 993-999
• Author(s): Suzanne P. Starling; Andrew P. Sirotnak; Kurt W. Heisler; Myra L. Barnes-Eley
• Date Published: September 2007
• Length: 7 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined characteristics of perpetrators of inflicted skeletal trauma.

Abstract

This study suggests that early targeting of parents and other caregivers, particularly men with information regarding appropriate expectations for infants and children, might aid in the prevention of inflicted fractures. The results indicated that the majority of the identified perpetrators of inflicted fractures were men, most often fathers, who tended to injure younger children; mothers were the second most common perpetrator of fractures. This is the first study to examine the specific characteristics of perpetrators of inflicted skeletal trauma. Findings indicated that men were the most common perpetrators of skeletal trauma in children with biological fathers and mothers’ boyfriend accounting for 58.2 percent of fractures. Biological mothers were the second most common group of fracture perpetrators. The proportions of girls and boys abused did not differ significantly by the sex of the perpetrator; however, children injured by men were younger than those injured by women. There is speculation that skeletal trauma and traumatic brain injury may have different triggers. Whereas crying in infants might trigger extreme irritation in an inexperienced caregiver leading to a shaking episode, fractures in infants and children might be more related to the frustrations of everyday parenting, thus accounting for the increase in perpetration by mothers. Alternate prevention measures should target males. Data also illustrated the high frequency of associated injuries with fractures. More than 63 percent of children had an additional injury other than their fractures. This finding suggests that screening for associated injuries in children with fractures is warranted. Findings also found that only 9 percent of fractures in children demonstrated bruises at the time of presentation; therefore, future studies should explore the association of fractures and bruising. Figures, table, references