Mechanism of violence-related injuries in children and age-related peculiarities

This is the first doctoral thesis in Lithuania dealing with physical traumas incurred by children as a result of violence. The aim and objectives of the dissertation is to identify the mechanism and characteristics of violence-related traumas in children by age and the place of violence as well as to provide criteria for identifying violence-related traumas in children for the first line physicians. The thesis analyses the rate of physical abuse against children in Lithuania according to the formal statistical data available from the agencies in Lithuania and on the basis of the data of 3,110 children treated for violence-related traumas during 1990–2007 at Vilnius University Children's Hospital that were statistically analysed by using SPSS 13.0 software and the traditional methods of biostatistics. It has been established that in the group of children aged 14-17 years, it was mostly boys who incurred traumas (81.1%). These traumas were predominantly sustained in public places (72.9%), less frequently in school (17.1 %) and even less frequently at home (10.0%). Nearly all infants (96.8%) and 83.9% of the children under 6 years of age who fell victims of abuse, suffered it at home, and in most cases the farther was the abuser (44.8% of the cases under the influence of alcohol). According to all the criteria of severity of traumas, the most severe traumas were related to violence at home, against infants and children under 3 years of age. They were more severe than accidental traumas. Violence-related traumas can be characterised by brain injuries, fractures of the nose and 5th metacarpal bone, multiple bruising, and stab, cut or shot wounds. In the night time, between 23:00 and 6:00 hours children sustained 19.8% of all violent traumas and in the group of 16-17 year olds – as many as 38.3%. This fact may help in planning preventive measures to fight violence against children. The thesis also provides an algorithm for physicians of how they could provide medical assistance to a child who sustained violence-related trauma