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On Trauma and Abuse in Children and Adolescents

Kids are some of the most vulnerable individuals in our society. Unfortunately, children can get injured. They can suffer traumatic injuries in auto accidents. Some kids slip and fall while playing and could suffer bone fractures. Others may fall out of trees, hurt themselves playing sports, or suffer stress fractures or growth plate injuries from overuse. There are a couple of examples of common injuries that children may experience, including:

• Fractures of the Radius: This is undoubtedly one of the most common injuries that kids will suffer. The radius is the larger of the two bones in the wrist and is broken when someone falls on an outstretched hand. Think about a boy who is running across the pool deck and subsequently, slips and falls. He extends his arms to protect his internal organs. However, his wrist takes the brunt of the force. This will lead to a radius fracture that typically requires a cast for around six weeks.
• Fractures of the Clavicle: Another common injury in children is a fracture of the clavicle. Also called the collarbone, this is broken when children slip and fall on their shoulder or their back. It is not uncommon for children to break their clavicle when they fall out of bed. Kids at a young age should have a guardrail on their bed when they are first transitioned to ensure they don't roll out of bed in their sleep. These are common fractures that could also require treatment in a sling or a cast for six weeks.

While most of the above injuries heal without incident, some children suffer more heinous injuries. A recent literature review looked at genital trauma in children and adolescents and how this can occur.

Mechanisms of Genital Trauma in Children

While this is often a taboo topic, it is important to discuss genital trauma in children because both accidental and abusive injury needs to be prevented. A team of experienced medical professionals published a recent paper discussing how this trauma can occur. Mechanisms that everyone should be aware of include:

• Straddle Injuries: These are injuries that occur when someone falls, and the area between his or her legs takes the brunt of the impact. This can happen when kids try and clear a hurdle, slide down a railing, ride a horse for too long, or fall on the crossbar of their bike. Caution is necessary for these situations.
• Chemical Burns: While this is unusual in a science lab, it can happen. More commonly, chemical and thermal burns to these areas are abusive in nature.
• Sexual Abuse: When sexual activity is forced on a child, trauma can result to the genital region. This includes tearing, bleeding, or even mutilation. It is important to document exactly what these injuries are so that they can be handled appropriately in a court of law.
• Insufflation Injuries: When children have issues with their urethra and bladder, a doctor may need to slide a scope up the urethra into the bladder. They fill the bladder with air so that they can see the entirety of the structure. However, this can lead to trauma as well.

Protecting Children Moving Forward

There are many ways that children can suffer trauma, including to their genital region, and understanding this trauma is the first step in its prevention. By learning how these injuries occur, they can be avoided before they happen. It is vital for everyone to understand what types of trauma are accidental and which are not so that everything can be investigated fully.

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