Trauma pattern recognition in pediatric fatalities: implications for surgical and forensic practice.
Description
Fracture patterns associated with specific causes of death have been documented in adult populations, for example, cranial trauma above the “hat line” often indicates assault, whereas axial loading fractures are more characteristic of falls. However, such patterns remain poorly described in pediatric cases. This study seeks to better characterize skeletal trauma in pediatric multi-trauma fatalities, beginning with an assessment of leading causes of death.
Postmortem CT scans were obtained from the New Mexico Decedent Image Database for individuals aged 0–18 years with causes of death recorded as Multiple Injuries or Head and Neck Injuries, yielding a sample of 246 cases. Deaths were categorized into nine groups: assault, motor vehicle accident (MVA)-passenger, fall, pedestrian MVA, falling object, animal attack, farm/industrial accident, aviation, and crush/suffocation. Frequencies were analyzed to assess patterns across age groups.
Overall, MVAs accounted for most fatalities (135/246, 54.9%) and were the leading cause of death for children aged ≥3 years. In contrast, pedestrian MVAs predominated in 3-year-olds, while assault was the most common cause among newborns and 1-year olds. No clear sex differences were observed. These trends mirror published findings on nonfatal pediatric injuries. Next steps in the project will include fracture types and patterns from CT scans in the data set. Identifying mechanism-specific fracture patterns in pediatric trauma may improve diagnostic accuracy, guide surgical planning, and support earlier recognition of non-accidental injuries. These insights could enhance trauma care, optimize surgical outcomes, and inform injury prevention strategies.
Citation Information
Bruton, Layne and Garvin, Heather, "Trauma pattern recognition in pediatric fatalities: implications for surgical and forensic practice." (2026). Office of Research DMU Research Symposium. 107.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/107
Trauma pattern recognition in pediatric fatalities: implications for surgical and forensic practice.
Fracture patterns associated with specific causes of death have been documented in adult populations, for example, cranial trauma above the “hat line” often indicates assault, whereas axial loading fractures are more characteristic of falls. However, such patterns remain poorly described in pediatric cases. This study seeks to better characterize skeletal trauma in pediatric multi-trauma fatalities, beginning with an assessment of leading causes of death.
Postmortem CT scans were obtained from the New Mexico Decedent Image Database for individuals aged 0–18 years with causes of death recorded as Multiple Injuries or Head and Neck Injuries, yielding a sample of 246 cases. Deaths were categorized into nine groups: assault, motor vehicle accident (MVA)-passenger, fall, pedestrian MVA, falling object, animal attack, farm/industrial accident, aviation, and crush/suffocation. Frequencies were analyzed to assess patterns across age groups.
Overall, MVAs accounted for most fatalities (135/246, 54.9%) and were the leading cause of death for children aged ≥3 years. In contrast, pedestrian MVAs predominated in 3-year-olds, while assault was the most common cause among newborns and 1-year olds. No clear sex differences were observed. These trends mirror published findings on nonfatal pediatric injuries. Next steps in the project will include fracture types and patterns from CT scans in the data set. Identifying mechanism-specific fracture patterns in pediatric trauma may improve diagnostic accuracy, guide surgical planning, and support earlier recognition of non-accidental injuries. These insights could enhance trauma care, optimize surgical outcomes, and inform injury prevention strategies.
