Non-accidental injuries are frequently treated by surgeons without the real reason behind the trauma being identified: The differential diagnosis of child abuse would not be considered in this circumstance. This 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 explained from a surgical point of view. It is of central importance to check, whether the trauma history according to the accompanying adults 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 position especially to prevent future abuse, bearing in mind the special relevance of its striking high recidivation frequency.
