Non-accidental injuries are frequently treated by surgeons without the
real reason behind the trauma being identified: The differential diag
nosis of child abuse would not be considered in this circumstance. Thi
s report gives hints as to the different aspects of this complex type
of injury. With our case unusual (atypical) injury patterns have been
shown and the diagnostic and therapeutic procedures with child abuse e
xplained from a surgical point of view. It is of central importance to
check, wheather the trauma history according to the accompanying adul
ts for the actual surgical type of injury is plausible. Incongruencies
here must lead to search for further signs of trauma or its residues.
When treating these children the surgeon is therefore in a key positi
on especially to prevent future abuse, bearing in mind the special rel
evance of its striking high recidivation frequency.