{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:46:17Z","timestamp":1788453977765,"version":"build-2803163510"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study aimed to describe which infants with a skull fracture (1) receive a child abuse pediatrician (CAP) consultation, (2) receive a skeletal survey, and (3) re-present to medical care before age 3 years with concerns for physical abuse.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a retrospective chart review of infants younger than 12 months who presented to the emergency department between January 1, 2005, and December 30, 2015, with a skull fracture. Medical records were reviewed for the skull fracture presentation and for all future medical evaluations at the same institution with concerns for physical abuse until 3 years of age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 366 infants with a skull fracture, a CAP was contacted for 272 (74%) and 76 (20.8%) infants who received a skeletal survey. Factors associated with skeletal survey acquisition included younger age (&lt;6 months), no history to explain the skull fracture, other injuries on examination, and social risk factors. Six children (1.6%) re-presented to medical care with concerns of physical abuse before age 3 years. Five of these infants did not have a skeletal survey at the time of their skull fracture, and 1 was likely a case of missed physical abuse at the time of the skull fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Discussion<\/jats:title>\n            <jats:p>Most skull fractures in infancy occur accidentally, and a skeletal survey may not be necessary for every infant. Obtaining a thorough history including social risk factors, performing a complete physical examination, and consulting with a CAP is an effective first step in the evaluation of physical abuse in infants with skull fractures.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002877","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T16:02:16Z","timestamp":1668096136000},"page":"e1678-e1683","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Selective Skeletal Surveys for Infants With Skull Fractures"],"prefix":"10.1097","volume":"38","author":[{"given":"Michelle M.","family":"Dominguez","sequence":"first","affiliation":[{"name":"Division of Pediatrics, Department of Pediatrics, The Alpert Medical School of Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Alpert Medical School of Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Alpert Medical School of Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Social Sciences, School of Public Health, Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"McCarten","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Alpert Medical School of Brown University, Providence, RI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Slingsby","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Pediatrics, The Alpert Medical School of Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1542\/pir.2018-0257","article-title":"Pediatric head trauma: a review and update","volume":"40","year":"2019","journal-title":"Pediatr Rev"},{"key":"bib3-20250504","first-page":"60","article-title":"Delayed identification of pediatric abuse-related fractures","volume":"125","year":"2009","journal-title":"Pediatrics"},{"key":"bib4-20250504","first-page":"e1337","article-title":"The evaluation of suspected child physical abuse","volume":"135","year":"2015","journal-title":"Pediatrics"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"991","DOI":"10.3109\/14767058.2015.1029913","article-title":"When is a post-mortem skeletal survey of the fetus indicated, and when not?","volume":"29","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1007\/s00247-017-3783-3","article-title":"Double-read of skeletal surveys in suspected non-accidental trauma: what we learned","volume":"47","year":"2017","journal-title":"Pediatr Radiol"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.chiabu.2017.11.004","article-title":"Skeletal surveys in young, injured children: a systematic review","volume":"76","year":"2018","journal-title":"Child Abuse Negl"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"e247","DOI":"10.1542\/peds.2008-2467","article-title":"Skeletal surveys in infants with isolated skull fractures","volume":"123","year":"2009","journal-title":"Pediatrics"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jpeds.2012.06.038","article-title":"Yield of skeletal surveys in children \u226418 months of age presenting with isolated skull fractures","volume":"162","year":"2013","journal-title":"J Pediatr"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1001\/jama.281.7.621","article-title":"Analysis of missed cases of abusive head trauma","volume":"281","year":"1999","journal-title":"JAMA"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.jpeds.2015.07.064","article-title":"Radiation exposure in imaging of suspected child abuse: benefits versus risks","volume":"167","year":"2015","journal-title":"J Pediatr"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1097\/TA.0b013e31828b7fc4","article-title":"Occult abusive injuries in infants with apparently isolated skull fractures","volume":"74","year":"2013","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002877","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:05:06Z","timestamp":1746381906000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002877"}},"subtitle":["Examining the Rates of Return to Medical Care for Concern of Physical Abuse"],"short-title":[],"issued":{"date-parts":[[2022,11,10]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002877","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2022,11,10]]}}}