A study of rib fractures in early childhood Version 1.0 [CAG Pilot]
Research type
Research Study
Full title
A study of rib fractures in early childhood using micro computed tomography and histology
IRAS ID
326134
Contact name
Emma Cheshire
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
When investigating child abuse, medicolegal professionals must work together to understand a death. During court proceedings, expert witnesses ideally should rely on a robust evidence base. A current widely discussed topic amongst paediatric/forensic pathologists is how/when rib fractures occur. Rib fractures are often seen in cases where a baby has been forcefully squeezed (often during shaking) but can occur through cardiopulmonary resuscitation (CPR). The challenge is a lack of controlled scientific studies (investigations of rib cages from non-abused infants). These studies would determine whether or not rib fractures occur in the absence of abuse. Appropriate injury detection/interpretation is essential for accurate diagnosis of child abuse. The East Midlands Forensic Pathology Unit (EMFPU), University of Leicester and Warwick Manufacturing group (WGM), University of Warwick are jointly in a unique position to undertake research is this area. Through a collaboration with West Midlands Police, WMG provide micro-CT imaging for forensic/paediatric pathologists upon the request of the police, for identification and visualisation of bone trauma, including of rib cages in abused deceased children. EMFPU have a track record for undertaking paediatric tissue research in relation to child abuse (REC ref 14/EM/0169) and have ongoing research links with local Coroners, and forensic, paediatric and bone pathologists. We are proposing a pilot study of 10 paediatric rib cages using micro-CT and histology to assess the occurrence of fractures in infants that have been resuscitated but not likely to have been subjected to abuse. Findings from these control cases will be compared to suspected abuse cases by retrospective review of autopsy reports. This will characterise injury patterns resulting from different mechanisms (eg abusive handling vs CPR). The prospective study of 10 rib cages would be a consented, autopsy- based study which would last for 2 years, taking place in the Leicester Royal Infirmary (LRI) mortuary. The cohort would include new-born babies to 3 year old children who require a post-mortem examination at the LRI.
REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
23/EM/0162
Date of REC Opinion
22 Sep 2023
REC opinion
Further Information Favourable Opinion