Recent Studies on Child Abuse and Neglect: Inflicted skeletal trauma: the relationship of perpetrators to their victims (2006)

Part of our ongoing survey of the child abuse literature on abuse perpetrators. The perpetrator information is highlighted in bold.

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Inflicted skeletal trauma: The relationship of perpetrators to their victims

Suzanne P. Starlinga, , Andrew P. Sirotnakb, Kurt W. Heislera and Myra L. Barnes-Eleya

aDepartment of Pediatrics, Eastern Virginia Medical School and Children's Hospital of The King's Daughters, Norfolk, VA, USA

bDepartment of Pediatrics, The Children's Hospital, University of Colorado School of Medicine, Denver, CO, USA

Received 23 February 2006; revised 5 January 2007; accepted 9 February 2007. Available online 17 September 2007.

Abstract
Objective
Although inflicted skeletal trauma is a very common presentation of child abuse, little is known about the perpetrators of inflicted skeletal injuries. Studies exist describing perpetrators of inflicted traumatic brain injury, but no study has examined characteristics of perpetrators of inflicted skeletal trauma.

Methods
All cases of suspected child physical abuse evaluated by the child abuse evaluation teams at Vanderbilt University Medical Center (January 1996 to August 2000) and at the Children's Hospital at Denver (January 1996 to December 1999) were reviewed for the presence of fractures. All children with inflicted fractures were entered into the study, and demographic data, investigative data, and identity of perpetrators were collected.

Results
There were a total of 630 fractures for 194 patients. The median number of fractures per patient was 2, and the maximum was 31. Sixty-three percent of children presented with at least one additional abusive injury other than the fracture(s). Perpetrators were identified in 79% of the cases. Nearly 68% of the perpetrators were male; 45% were the biological fathers. The median age of the children abused by males (4.5 months) significantly differed from the median age of those abused by females (10 months) (p = .003).

Conclusion
In the cases where a perpetrator of inflicted fractures could be identified, the majority were men, most commonly the biological fathers. Children injured by men were younger than those injured by women.