{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:46:19Z","timestamp":1788453979510,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We sought to determine the frequency and patterns of delayed medical care seeking for young children with skull fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified accidental skull fractures &lt;4\u00a0years old, 2011\u20132012. Child abuse paediatricians abstracted retrospective data and paediatric radiologists re\u2010reviewed images. \u2018Delays\u2019 were defined as presentation at \u22656\u00a0h. \u2018Minor accidents\u2019 included falls &lt;4 feet and low force trauma, while \u2018major accidents\u2019 included higher height falls and major force events. We studied the frequency and duration of care delays, the signs or symptoms leading to care, and the duration of delays after signs or symptoms developed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and ten children had accidental skull fractures. Delays were less likely with major accidents (4.9%), than with minor accidents (25.8%) (RR\u00a0=\u00a00.32 [0.15\u20130.70]). Children came to care for scalp swelling (STS) (39%), the injury event (36.2%), altered consciousness (15.2%) and vomiting (10.5%). Delayed onset of STS (78.6%) caused most delayed care. Early STS was firm, (17.6%) versus delayed (5.0%), as opposed to soft or fluctuant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Delayed care seeking is common for minor, but not major accidental infant and toddler skull fractures. Most followed delayed onset of signs and symptoms. Delayed care seeking alone should not imply child abuse.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.15660","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T21:30:10Z","timestamp":1605130210000},"page":"1890-1894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Delays in care seeking for young children with accidental skull fractures are common"],"prefix":"10.1111","volume":"110","author":[{"given":"James B.","family":"Metz","sequence":"first","affiliation":[{"name":"Department of Paediatrics University of Vermont Children\u2019s Hospital University of Vermont Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Otjen","sequence":"additional","affiliation":[{"name":"Department of Radiology Seattle Children's Hospital University of Washington Seattle Washington 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