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dc.contributor.advisorKieser, Jules
dc.contributor.advisorTheis, Jean-Claude
dc.contributor.authorBlackburne, William Bligh
dc.date.available2015-03-23T20:21:51Z
dc.date.copyright2015
dc.identifier.citationBlackburne, W. B. (2015). Rib Fractures in Infants: Retrospective Survey of Fractures and Biomechanical Study. (Thesis, Bachelor of Medical Science with Honours). University of Otago. Retrieved from http://hdl.handle.net/10523/5565en
dc.identifier.urihttp://hdl.handle.net/10523/5565
dc.description.abstractLiterature suggests that rib fractures are highly associated with abuse and the present understanding is that antero-posterior compression associated with the ‘shaken baby syndrome’ is their cause. However, this mechanism rests on a number of assumptions with little experimental data to support them. Recent work using a porcine model of fractures suggests that, in the case of lateral fractures this may be highly unlikely. This work shows a feasible alternate mechanism, that of blunt force trauma (BFT), for the cause of these lateral fractures. A piglet model is used and shows the ease with which ribs fracture as a result of BFT, compared to the difficulty of fracture seen previously in compressive injury. The initial development of a computational simulation of these ribs for use in injury scenarios is also outlined here. Secondly, skeletal surveys from New Zealand’s largest children’s care facility, Starship Hospital, were examined to give a picture of non-accidental injury (NAI) and how its patterns compare with accidental injury in New Zealand. It has been found that, as in foreign studies, there are a number of lesions highly associated with abuse and these include rib fractures, which are highly specific (97%) for NAI. Unusuallyhigh frequencies of lateral-type rib fractures (46.4%) were found and half the cases were found to be unilateral. This is not wholly in line with the currently accepted idea that rib fracture is due to antero-posterior compression, in which bilateral, posterior fractures are said to be most common. Overall, this work brings into question the traditional mechanism of rib fractures, provides a highly useful snapshot of abusive injury in NZ and also sets a strong foundation for future work.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.publisherUniversity of Otago
dc.rightsAll items in OUR Archive are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
dc.subjectRib fracture
dc.subjectbiomechanics
dc.subjectforensics
dc.subjectinfant
dc.subjectchild abuse
dc.subjectshaken baby syndrome
dc.subjectabuse
dc.subjectchild
dc.titleRib Fractures in Infants: Retrospective Survey of Fractures and Biomechanical Study.
dc.typeThesis
dc.date.updated2015-03-23T11:23:10Z
dc.language.rfc3066en
thesis.degree.disciplineDunedin School of Medicine
thesis.degree.nameBachelor of Medical Science with Honours
thesis.degree.grantorUniversity of Otago
thesis.degree.levelHonours
otago.openaccessOpen
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