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    What factors affect the identification and reporting of child abuse-related fractures?

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    Author
    Lane, W.G.
    Dubowitz, H.
    Date
    2007
    Journal
    Clinical Orthopaedics and Related Research
    Publisher
    Lippincott Williams and Wilkins
    Type
    Conference Paper
    
    Metadata
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    See at
    https://doi.org/10.1097/BLO.0b013e31805c0849
    Abstract
    Child abuse is a serious problem in the United States. Because orthopaedic surgeons are responsible for identifying and reporting suspicious fractures to child protective services, we asked two primary questions: (1) How skilled are orthopaedists in distinguishing abuse-related from noninflicted fractures and making appropriate child protective services reports?; and (2) Are decisions influenced by orthopaedist training or by the race or socioeconomic status of injured children? We developed and mailed a questionnaire containing 10 case vignettes to 974 US orthopaedists. Respondents assessed the likelihood of abuse and need to report to child protective services. Two versions of the questionnaire differed by the race and socioeconomic status of vignette families. Average respondent scores were 79% for correct diagnoses and 73% for correct reporting decisions. Pediatric orthopaedists had higher adjusted scores for identifying abuse-related versus noninflicted injuries (82% versus 73%) and for appropriately reporting to child protective services (76% versus 66%) compared with general orthopaedists. Both groups had difficulty distinguishing abuse-related from noninflicted long-bone fractures in infants and toddlers. We found no differences in appropriate identification or reporting of fractures by race but did find differences by social class. Additional training in identifying abuse-related long-bone fractures appears necessary. Orthopaedists should consider the potential for bias when assessing children with fractures for possible abuse. Copyright 2007 Lippincott Williams & Wilkins, Inc.
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-34548364217&doi=10.1097%2fBLO.0b013e31805c0849&partnerID=40&md5=abef34e0cf997a80e4baf9a148c2b43b; http://hdl.handle.net/10713/11880
    ae974a485f413a2113503eed53cd6c53
    10.1097/BLO.0b013e31805c0849
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    Dr. Howard Dubowitz

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