Types of skull fracture in children referred with skull fracture and/or intracranial injury whose injuries were diagnosed as accidental or abusive head trauma (AHT), by age
| All accidental and AHT | Under 2 years old | Over 2 years old | ||||||
|---|---|---|---|---|---|---|---|---|
| Accidental | AHT | Accidental | AHT | |||||
| N | N (%) | N (%) | OR (95% CI)† | N (%) | N (%) | OR (95% CI)† | ||
| All skull fractures | 147 | 62 (52) | 57 (48) | 15 (54) | 13 (46) | |||
| All simple | Yes | 90 | 45 (58) | 32 (42) | 0.5 (0.2 to 1.1) | 9 (69) | 4 (31) | 0.3 (0.05 to 1.8) |
| No | 17 (40) | 25 (60) | 6 (40) | 9 (60) | ||||
| Simple with ICI | Yes | 51 | 19 (43) | 25 (57) | 1.8 (0.8 to 4.0) | 5 (71) | 2 (29) | 0.4 (0.03 to 3.0) |
| No | 43 (57) | 32 (43) | 10 (48) | 11 (52) | ||||
| Parietal | Yes | 61 | 37 (65) | 20 (35) | 0.4 (0.2 to 0.8)* | 4 (100) | 0 (0) | 0 (0 to 1.6) |
| No | 25 (40) | 37 (60) | 11 (46) | 13 (54) | ||||
| Occipital | Yes | 17 | 6 (46) | 7 (54) | 1.3 (0.3 to 5.0) | 1 (25) | 3 (75) | 4.2 (0.3 to 236) |
| No | 56 (53) | 50 (47) | 14 (58) | 10 (42) | ||||
| Temporal | Yes | 2 | 1 (50) | 1 (50) | 1.1 (0.01 to 86.9) | 0 | 0 | – |
| No | 61 (52) | 56 (48) | 15 (54) | 13 (46) | ||||
| Frontal | Yes | 2 | 0 (0) | 2 (100) | ∝ (0.2 to ∝) | 0 | 0 | – |
| No | 62 (53) | 55 (47) | 15 (54) | 13 (46) | ||||
| Other‡ | Yes | 8 | 1 (33) | 2 (67) | 2.2 (0.1 to 133) | 4 (80) | 1 (20) | 0.2 (0.0 to 2.9) |
| No | 61 (53) | 55 (47) | 11 (48) | 12 (52) | ||||
| All complex | Yes | 57 | 17 (40) | 25 (60) | 2.1 (0.9 to 4.8) | 6 (40) | 9 (60) | 3.4 (0.6 to 21.9) |
| No | 45 (58) | 32 (42) | 9 (69) | 4 (31) | ||||
| Complex with ICI | Yes | 40 | 6 (21) | 22 (79) | 5.8 (2.0 to 19.2)** | 4 (33) | 8 (67) | 4.4 (0.7 to 29.5) |
| No | 56 (62) | 35 (38) | 11 (69) | 5 (31) | ||||
| Multiple | Yes | 19 | 7 (39) | 11 (61) | 1.9 (0.6 to 6.2) | 0 (0) | 1 (100) | ∝ (0.03 to ∝) |
| No | 55 (54) | 46 (46) | 15 (56) | 12 (44) | ||||
| BOS | Yes | 18 | 4 (50) | 4 (50) | 1.1 (0.2 to 6.2) | 4 (40) | 6 (60) | 2.4 (0.4 to 15.5) |
| No | 58 (52) | 53 (48) | 11 (61) | 7 (39) | ||||
| Comminuted | Yes | 11 | 3 (30) | 7 (70) | 2.8 (0.6 to 17.2) | 1 (100) | 0 (0) | 0 (0 to 45.0) |
| No | 59 (54) | 50 (46) | 14 (52) | 13 (48) | ||||
| Depressed | Yes | 5 | 2 (50) | 2 (50) | 1.1 (0.08 to 15.5) | 0 (0) | 1 (100) | ∝ (0.03 to ∝) |
| No | 60 (52) | 55 (48) | 15 (56) | 12 (44) | ||||
| Compound | Yes | 4 | 1 (50) | 1 (50) | 1.1 (0.01 to 86.9) | 1 (50) | 1 (50) | 1.2 (0.01 to 98.0) |
| No | 61 (52) | 56 (48) | 14 (54) | 12 (46) | ||||
*p<0.05, **p<0.001, Fisher's exact test.
†OR with 95% CI, for the odds of AHT versus accidental.
‡‘Other’ includes three occipitoparietal, two temporoparietal, one frontoparietal and two sutural.
BOS, base of skull; ICI, intracranial injury.