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An evaluation of the differences in paediatric skeletal trauma between fatal simple short falls and physical abuse blunt impact loads: An international multicentre pilot study
•Of forensic paediatric deaths, short falls comprised 0.1% and physical abuse 0.6%.•Pilot findings suggest possible differences between short falls and physical abuse.•Simple short falls resulted in simple linear neurocranial fractures.•Physical abuse resulted in linear or complex skull fractures an...
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| Published in: | Forensic science international 2021-06, Vol.323, p.110788-110788, Article 110788 |
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| creator | Rowbotham, Samantha K. Blumenthal, Ryan Delabarde, Tania Legrand, Laurence van der Walt, Elizabeth Sutherland, Tom Lockhat, Zarina Arthurs, Owen J. |
| description | •Of forensic paediatric deaths, short falls comprised 0.1% and physical abuse 0.6%.•Pilot findings suggest possible differences between short falls and physical abuse.•Simple short falls resulted in simple linear neurocranial fractures.•Physical abuse resulted in linear or complex skull fractures and postcranial trauma.•Pilot data forms the foundation of the Registry of Paediatric Fatal Fractures (RPFF).
In cases where a deceased child exhibits trauma as a result of a physical abuse blunt impact load, a parent/caregiver may provide a simple short fall (SSF) as the justification for that trauma. The skeletal fractures remain difficult to differentiate between a SSF and physical abuse however, as both are the result of a blunt impact load, and are therefore biomechanically alike, and the rare nature of these fatalities means only anecdotal research has been available to validate such claims. The aim of this pilot study was to investigate if there may be differences in the skeletal fracture patterns and types resulting from SSFs compared with those resulting from physical abuse blunt impacts. Paediatric ( |
| doi_str_mv | 10.1016/j.forsciint.2021.110788 |
| format | article |
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In cases where a deceased child exhibits trauma as a result of a physical abuse blunt impact load, a parent/caregiver may provide a simple short fall (SSF) as the justification for that trauma. The skeletal fractures remain difficult to differentiate between a SSF and physical abuse however, as both are the result of a blunt impact load, and are therefore biomechanically alike, and the rare nature of these fatalities means only anecdotal research has been available to validate such claims. The aim of this pilot study was to investigate if there may be differences in the skeletal fracture patterns and types resulting from SSFs compared with those resulting from physical abuse blunt impacts. Paediatric (<10 years) cases of fatal SSFs (≤1.5 m) and physical abuse were collected from the Victorian Institute of Forensic Medicine (Australia), Institut Médico-Légal de Paris (France), University of Pretoria (South Africa) and Great Ormond Street Hospital (England). For each case the intrinsic and extrinsic variables were recorded from medico-legal reports and skeletal trauma was documented using post-mortem computed tomography scans and/or skeletal surveys. Three SSFs and 18 physical abuse cases were identified. Of the SSF cases, two exhibited fractures; both of which were simple linear neurocranial fractures. Comparatively, 12 of the physical abuse cases exhibited fractures and these were distributed across the skeleton; 58% located only in the skull, 17% only in the post-cranial and 25% located in both. Skull fracture types were single linear, multiple linear and comminuted. This pilot study suggests, anecdotally, there may be differences in the fracture patterns and types between blunt impact loads resulting from a SSF and physical abuse. This data will form the foundation of the Registry of Paediatric Fatal Fractures (RPFF) which, with further multicentre contributions, would allow this finding to be validated.</description><identifier>ISSN: 0379-0738</identifier><identifier>EISSN: 1872-6283</identifier><identifier>DOI: 10.1016/j.forsciint.2021.110788</identifier><identifier>PMID: 33915490</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Biomechanics ; Blunt impact load ; Caregivers ; Computed tomography ; Fatalities ; Forensic anthropology ; Forensic pathology ; Forensic science ; Forensic sciences ; Fractures ; Impact analysis ; Impact loads ; Injuries ; Law enforcement ; Load ; Medical imaging ; Paediatric skeletal trauma ; Pediatrics ; Physical abuse ; Registry ; Simple short fall ; Skeleton ; Skull ; Trauma</subject><ispartof>Forensic science international, 2021-06, Vol.323, p.110788-110788, Article 110788</ispartof><rights>2021</rights><rights>Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Limited Jun 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c345t-8933713fcf380235a5380573754a82ab56afa747cf467abf0b74901b1c5b060b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33915490$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rowbotham, Samantha K.</creatorcontrib><creatorcontrib>Blumenthal, Ryan</creatorcontrib><creatorcontrib>Delabarde, Tania</creatorcontrib><creatorcontrib>Legrand, Laurence</creatorcontrib><creatorcontrib>van der Walt, Elizabeth</creatorcontrib><creatorcontrib>Sutherland, Tom</creatorcontrib><creatorcontrib>Lockhat, Zarina</creatorcontrib><creatorcontrib>Arthurs, Owen J.</creatorcontrib><title>An evaluation of the differences in paediatric skeletal trauma between fatal simple short falls and physical abuse blunt impact loads: An international multicentre pilot study</title><title>Forensic science international</title><addtitle>Forensic Sci Int</addtitle><description>•Of forensic paediatric deaths, short falls comprised 0.1% and physical abuse 0.6%.•Pilot findings suggest possible differences between short falls and physical abuse.•Simple short falls resulted in simple linear neurocranial fractures.•Physical abuse resulted in linear or complex skull fractures and postcranial trauma.•Pilot data forms the foundation of the Registry of Paediatric Fatal Fractures (RPFF).
In cases where a deceased child exhibits trauma as a result of a physical abuse blunt impact load, a parent/caregiver may provide a simple short fall (SSF) as the justification for that trauma. The skeletal fractures remain difficult to differentiate between a SSF and physical abuse however, as both are the result of a blunt impact load, and are therefore biomechanically alike, and the rare nature of these fatalities means only anecdotal research has been available to validate such claims. The aim of this pilot study was to investigate if there may be differences in the skeletal fracture patterns and types resulting from SSFs compared with those resulting from physical abuse blunt impacts. Paediatric (<10 years) cases of fatal SSFs (≤1.5 m) and physical abuse were collected from the Victorian Institute of Forensic Medicine (Australia), Institut Médico-Légal de Paris (France), University of Pretoria (South Africa) and Great Ormond Street Hospital (England). For each case the intrinsic and extrinsic variables were recorded from medico-legal reports and skeletal trauma was documented using post-mortem computed tomography scans and/or skeletal surveys. Three SSFs and 18 physical abuse cases were identified. Of the SSF cases, two exhibited fractures; both of which were simple linear neurocranial fractures. Comparatively, 12 of the physical abuse cases exhibited fractures and these were distributed across the skeleton; 58% located only in the skull, 17% only in the post-cranial and 25% located in both. Skull fracture types were single linear, multiple linear and comminuted. This pilot study suggests, anecdotally, there may be differences in the fracture patterns and types between blunt impact loads resulting from a SSF and physical abuse. This data will form the foundation of the Registry of Paediatric Fatal Fractures (RPFF) which, with further multicentre contributions, would allow this finding to be validated.</description><subject>Biomechanics</subject><subject>Blunt impact load</subject><subject>Caregivers</subject><subject>Computed tomography</subject><subject>Fatalities</subject><subject>Forensic anthropology</subject><subject>Forensic pathology</subject><subject>Forensic science</subject><subject>Forensic sciences</subject><subject>Fractures</subject><subject>Impact analysis</subject><subject>Impact loads</subject><subject>Injuries</subject><subject>Law enforcement</subject><subject>Load</subject><subject>Medical imaging</subject><subject>Paediatric skeletal trauma</subject><subject>Pediatrics</subject><subject>Physical abuse</subject><subject>Registry</subject><subject>Simple short fall</subject><subject>Skeleton</subject><subject>Skull</subject><subject>Trauma</subject><issn>0379-0738</issn><issn>1872-6283</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqFkU1v1DAQhi0EotvCXwBLXLhk8UccJ9xWFVCkSlzgbDnOWOvFsYPttNpfxV_E2y09cOE00swz73y8CL2lZEsJ7T4ctjambJwLZcsIo1tKiez7Z2hDe8majvX8OdoQLoeGSN5foMucD4QQIVj3El1wPlDRDmSDfu8ChjvtV11cDDhaXPaAJ2ctJAgGMnYBLxomp0tyBuef4KFoj0vS66zxCOUeIGCrT8ns5sUDzvuYSk15n7EOE172x-xMretxzYBHv4aCK6pNwT7qKX_EdY16C6TwsEdF59UXZyCUBHhxPhacyzodX6EXVTfD68d4hX58_vT9-qa5_fbl6_XutjG8FaXpB84l5dZY3hPGhRY1CsmlaHXP9Cg6bbVspbFtJ_VoySjrO-hIjRhJR0Z-hd6fdZcUf62Qi5pdNuC9DhDXrJhgpO_aqlfRd_-gh7jWQ_wDNTA28EFWSp4pk2LOCaxakpt1OipK1MlTdVBPnqqTp-rsae1886i_jjNMT31_TazA7gxAfcidg6Sqysm8ySUwRU3R_XfIH2Cfuho</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Rowbotham, Samantha K.</creator><creator>Blumenthal, Ryan</creator><creator>Delabarde, Tania</creator><creator>Legrand, Laurence</creator><creator>van der Walt, Elizabeth</creator><creator>Sutherland, Tom</creator><creator>Lockhat, Zarina</creator><creator>Arthurs, Owen J.</creator><general>Elsevier B.V</general><general>Elsevier 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between fatal simple short falls and physical abuse blunt impact loads: An international multicentre pilot study</title><author>Rowbotham, Samantha K. ; Blumenthal, Ryan ; Delabarde, Tania ; Legrand, Laurence ; van der Walt, Elizabeth ; Sutherland, Tom ; Lockhat, Zarina ; Arthurs, Owen J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c345t-8933713fcf380235a5380573754a82ab56afa747cf467abf0b74901b1c5b060b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biomechanics</topic><topic>Blunt impact load</topic><topic>Caregivers</topic><topic>Computed tomography</topic><topic>Fatalities</topic><topic>Forensic anthropology</topic><topic>Forensic pathology</topic><topic>Forensic science</topic><topic>Forensic sciences</topic><topic>Fractures</topic><topic>Impact analysis</topic><topic>Impact loads</topic><topic>Injuries</topic><topic>Law 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Int</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>323</volume><spage>110788</spage><epage>110788</epage><pages>110788-110788</pages><artnum>110788</artnum><issn>0379-0738</issn><eissn>1872-6283</eissn><abstract>•Of forensic paediatric deaths, short falls comprised 0.1% and physical abuse 0.6%.•Pilot findings suggest possible differences between short falls and physical abuse.•Simple short falls resulted in simple linear neurocranial fractures.•Physical abuse resulted in linear or complex skull fractures and postcranial trauma.•Pilot data forms the foundation of the Registry of Paediatric Fatal Fractures (RPFF).
In cases where a deceased child exhibits trauma as a result of a physical abuse blunt impact load, a parent/caregiver may provide a simple short fall (SSF) as the justification for that trauma. The skeletal fractures remain difficult to differentiate between a SSF and physical abuse however, as both are the result of a blunt impact load, and are therefore biomechanically alike, and the rare nature of these fatalities means only anecdotal research has been available to validate such claims. The aim of this pilot study was to investigate if there may be differences in the skeletal fracture patterns and types resulting from SSFs compared with those resulting from physical abuse blunt impacts. Paediatric (<10 years) cases of fatal SSFs (≤1.5 m) and physical abuse were collected from the Victorian Institute of Forensic Medicine (Australia), Institut Médico-Légal de Paris (France), University of Pretoria (South Africa) and Great Ormond Street Hospital (England). For each case the intrinsic and extrinsic variables were recorded from medico-legal reports and skeletal trauma was documented using post-mortem computed tomography scans and/or skeletal surveys. Three SSFs and 18 physical abuse cases were identified. Of the SSF cases, two exhibited fractures; both of which were simple linear neurocranial fractures. Comparatively, 12 of the physical abuse cases exhibited fractures and these were distributed across the skeleton; 58% located only in the skull, 17% only in the post-cranial and 25% located in both. Skull fracture types were single linear, multiple linear and comminuted. This pilot study suggests, anecdotally, there may be differences in the fracture patterns and types between blunt impact loads resulting from a SSF and physical abuse. This data will form the foundation of the Registry of Paediatric Fatal Fractures (RPFF) which, with further multicentre contributions, would allow this finding to be validated.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>33915490</pmid><doi>10.1016/j.forsciint.2021.110788</doi><tpages>1</tpages></addata></record> |
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| ispartof | Forensic science international, 2021-06, Vol.323, p.110788-110788, Article 110788 |
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| source | Elsevier |
| subjects | Biomechanics Blunt impact load Caregivers Computed tomography Fatalities Forensic anthropology Forensic pathology Forensic science Forensic sciences Fractures Impact analysis Impact loads Injuries Law enforcement Load Medical imaging Paediatric skeletal trauma Pediatrics Physical abuse Registry Simple short fall Skeleton Skull Trauma |
| title | An evaluation of the differences in paediatric skeletal trauma between fatal simple short falls and physical abuse blunt impact loads: An international multicentre pilot study |
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