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Inclusion criteria

See evidence sheets and critical appraisal forms for each year’s update.

 General criteria

Inclusion

Exclusion

Papers with all evidence types

Personal practice

English and non-English papers

Review papers

Papers from conferences – paediatric, radiology, orthopaedic

Management of fractures papers

Patients between 0-17 years of age

 

 

Papers where the population included adults and children

Studies of non-abusive data only

Methodologically flawed papers

 

Additional criteria for specific review questions

1. Which fractures are indicative of abuse?

Inclusion

Exclusion

General inclusion criteria plus:

General exclusion criteria plus:

Comparative studies of children less than 17 years of age with fractures either abusive or non-abusive

Rank of abuse is 4 or 5 or mixed rank where relevant cases cannot be extracted

Non-comparative studies of other fracture types found in abuse where comparative data was unavailable

 

Studies addressing abusive / non-abusive fractures only

Single case reports

Studies of outcome or management of abusive fractures

 

2. What is the evidence for radiological dating of fractures in children?

Inclusion

Exclusion

General inclusion criteria plus:

General exclusion criteria plus:

Primary research addressing how you can date fractures radiologically in children up to 17 years of age

Underlying bone disease was present

Criteria for dating was not detailed

 

3. What radiological investigations should be performed to identify fractures in suspected child abuse?

Inclusion

Exclusion

General inclusion criteria plus:

General exclusion criteria plus:

Children (0-17) who had radiological investigations to identify bone fractures in suspected child abuse

Studies where details on the yield from the investigations were not available

Fatal abuse

 

4. Does cardiopulmonary resuscitation cause rib fractures in children?

Inclusion

Exclusion

General inclusion criteria plus:

General exclusion criteria plus:

External closed cardiopulmonary resuscitation (CPR)

Studies relating to complications or outcomes of CPR (other than rib fractures)

No underlying bone disease or child abuse as the cause of collapse

Inadequate quality of confirmation of fractures

Incidence of associated rib fractures was recorded

 

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