CHAMP Education for Child Abuse Medical Providers

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So what is the conundrum with skull fractures? Why do we get so worried about skull fractures in children and why is there such variation in how people think about skull fractures and whether to report to Child Protective Services? The main concern I believe is that we are uncomfortable with the potential for missing abusive head trauma which is a real concern. We know from previous studies that medical providers miss approximately 1/3 of cases of abusive head trauma. That is, when we look at children who have been diagnosed with abusive head trauma, we see that about 1/3 had been seen previously by a medical provider and misdiagnosed. I would also suggest that our understanding of the infant skull and the biomechanics of skull fractures is somewhat limited and still evolving.