Radiologic Assessment of Skull Fracture Healing in Young Children.

Autor:	Harper NS; From the Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN., Eddleman S; Driscoll Children's Hospital, Corpus Christi, TX., Shukla K; Cox Medical Center South, Springfield, MO., Narcise MV; Driscoll Children's Hospital, Corpus Christi, TX., Padhye LJ; Department of Family Medicine and Community Health, University of Minnesota, M Health Fairview St. Joseph's Hospital., Peterson LJ; From the Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN., Murati MA; Department of Radiology, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN., George CLS; From the Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
Jazyk:	angličtina
Zdroj:	Pediatric emergency care [Pediatr Emerg Care] 2021 Apr 01; Vol. 37 (4), pp. 213-217.
DOI:	10.1097/PEC.0000000000002215
Abstrakt:	Background: Skull fractures are commonly seen after both accidental and nonaccidental head injuries in young children. A history of recent trauma may be lacking in either an accidental or nonaccidental head injury event. Furthermore, skull fractures do not offer an indication of the stage of healing on radiologic studies because they do not heal with callus formation as seen with long bone fractures. Thus, a better understanding on the timing of skull fracture resolution may provide guidance on the medical evaluation for accidental or nonaccidental head injury. Objective: The aim of the study was to determine the time required for radiographic skull fracture resolution in children younger than 24 months. Methods: This was a retrospective observational analysis of children younger than 24 months referred with skull fractures between January 2008 and December 2012. Analysis included children with accidental head injuries with a known time interval since injury and a negative skeletal survey who underwent serial radiographic studies. Complete healing of a skull fracture was defined as resolution of fracture lucency by radiograph. Results: Of the 26 children who met inclusion criteria, 11 (42.3%) demonstrated resolution of skull fracture(s) on follow-up imaging. Fracture resolution on radiologic studies ranged from 2 to 18 weeks. Twelve fractures in 10 children demonstrated fracture resolution at 10 or more weeks after injury. Conclusions: Healing or resolution of a skull fracture can take months in children younger than 24 months. With the high variability in skull fracture presentation and large window to fracture resolution, unexplained or multiple skull fractures in children younger than 24 months may be the result of a single or multiple events of head trauma. Competing Interests: Disclosure: N.S.H.'s institution has received payment for expert witness court testimony that has been provided in cases of suspected child abuse in which she has been subpoenaed to testify. N.S.H. and S.E. have provided paid expert testimony in cases of suspected child abuse. The other authors declare no conflict of interest. (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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