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Child Maltreatment
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Abusive Head Trauma? A Biomechanics-Based Approach

Kent P. Hymel

U.S. Air Force Medical Corps

Faris A. Bandak

The George Washington University

Michael D. Partington

University of Colorado Health Sciences Center and The Children's Hospital

Ken R. Winston

University of Colorado Health Sciences Center and the Children's Hospital

Medical professionals frequently evaluate infants and children with head trauma. If the child's cranial injuries are not explained by the history, child abuse must be considered. A significant body of research regarding cranial injury mechanisms is available. This article presents a synthesis of a subset of the biomechanics literature relevant to head injury. The potential application of this knowledge base is explored through five questions: (a) What physical laws govern the response of the head-brain complex to the application of a mechanical force? (b) What are the causal mechanisms of head injury? (c) What properties of living tissues affect responses to the application of a mechanical force? (d) How can specific cranial injuries be linked to their biomechanical origins? and (e) Can the biomechanical history explain the cranial injuries? The authors propose a biomechanics-based paradigm for analysis of pediatric head trauma and seek a qualitative rather than a quantitative understanding.

Child Maltreatment, Vol. 3, No. 2, 116-128 (1998)
DOI: 10.1177/1077559598003002006
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