Straddle injuries--is current practice safe?

Genital injuries may be markers of sexual abuse and child protection issues should be considered when case present. This study evaluates the quality of history taking and the physical examination of children who present with straddle injuries to an accident and emergency department. A retrospective analysis of the accident and emergency case notes of children who presented over a 12-month period with straddle injuries was undertaken. A scoring system of risk factors was devised to help identify children at risk of sexual abuse and applied to the case notes. The results showed that the documentation of injuries was inadequate in the majority of cases, increasing the risk that cases of sexual abuse may be missed. Core questions which aid in the selection of children who require further evaluation have previously been identified. Utilizing the information from our findings we have devised a protocol for the assessment of children with straddle injuries which includes an action plan for the management of such cases.