Purpose

The authors provide a comprehensive framework with which to approach paediatric calvarial injury sustained as a result of suspected abusive head trauma (AHT). This is achieved through the presentation of a case series set in the context of the unique morphology of the infant skull and the possible diagnostic pitfalls which may arise due to the presence of variant anatomy or other mimicking conditions.

Methods

A retrospective analysis of sixty-three patients referred to our institution with suspected AHT was carried out. Seventeen patients with skull fractures were identified and their fractures were described in terms of anatomical location, type and course. Our data was then interpreted in the light of known anatomical fracture mimics and the available literature on the subject.

Results

Forty-two skull fractures were identified and described in our cohort, most of which were simple linear fractures of the parietal bones (33%). There were also a substantial number of complex stellate fractures, namely of the parietal (29%) and occipital (10%) bones. Eleven fracture mimics including accessory sutures and wormian bones were also identified in this cohort.

Conclusions

Our study supports and builds on the existing literature, thereby offering a more complete view of the spectrum of calvarial damage sustained as a result of AHT in the context of its diagnostic pitfalls.

中文翻译：

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虐待性颅脑外伤中的颅骨骨折：单中心经验和文献回顾。

目的

作者提供了一个综合的框架，可以用来应对因怀疑的头部虐待（AHT）而导致的小儿颅盖膜损伤。这是通过在婴儿头骨独特的形态以及可能由于存在不同的解剖结构或其他模仿条件而引起的可能出现的诊断缺陷的背景下提出一系列病例来实现的。

方法

回顾性分析了转诊至我院的63例疑似AHT患者。确定了17例颅骨骨折患者，并根据解剖位置，类型和病程描述了他们的骨折。然后根据已知的解剖学骨折模拟和有关该主题的现有文献解释我们的数据。

结果

在我们的队列研究中，发现并描述了42个颅骨骨折，其中大多数是顶骨的简单线性骨折（33％）。还存在大量复杂的星状骨折，即顶骨（29％）和枕骨（10％）。在该队列中还确定了11种骨折模拟物，包括辅助缝合线和骨头。

结论

我们的研究支持并建立在现有文献的基础上，从而更全面地了解了AHT在其诊断缺陷方面所遭受的颅盖膜损害的范围。