Unsuspected Trauma With Multiple Skeletal Injuries During Infancy and Childhood

This report concerns the experience at the Children's Hospital of Pittsburgh with 50 children who had skeletal lesions considered to be the result of trauma. The peak age incidence was 3 months. The presenting complaints included disability of an extremity, skin lesions, failure to do well, convulsions, vomiting and diarrhea, and large head. The initial impressions of house officers ranged through the gamut of possible skeletal disorders and blood dyscrasias. Interviews with the parents indicated that the families of these injured children were characterized by parental failure, caused by immaturity, failure to accept responsibility, and other psychosocial afflictions. The seriousness of this disease is indicated by the deaths of five of the infants and the continued injury of others after their return home from the hospital.