Picini Marcos, Gonçalves João Rodolfo Radtke, Bringhenti Thagla, Forlin Edilson
Hospital Pequeno Príncipe, Curitiba, PR, Brazil.
Pontifícia Universidade Católica, Faculdade de Medicina, Curitiba, PR, Brazil.
Rev Bras Ortop. 2017 May 11;52(3):284-290. doi: 10.1016/j.rboe.2017.05.004. eCollection 2017 May-Jun.
This study evaluated the epidemiological profile of patients with suspected physical abuse, especially regarding the occurrence of fractures, treated in a referral hospital.
The authors reviewed all reports of suspected abuse against children and adolescents (AACA) in this hospital from January 2005 to December 2015. They were assessed and separated by month and year. The characteristics of the victims of physical abuse with occurrence of fractures were studied. The features of the fractures were evaluated in those patients with available radiographs.
Of the 3125 notifications, 500 were classified as physical injuries; of these, 63 had fractures. An annual progressive increase in notifications was observed. As for age group, 50 patients (80.6%) were up to three years old and 36 (58%) up to one year. Most were male (60%) and the likely aggressors were mother alone and both parents (27.5% each). In 30 patients with available images, fractures of long bones (femur, tibia, and humerus) predominated (71%), as well as a single fracture line (74%), diaphyseal location (73%), and a transverse line (57%). There were two deaths in fracture cases (3%).
All orthopedists should be alert to suspected AACA in children with trauma below the age of three, even without classic signs of abuse.
本研究评估了在一家转诊医院接受治疗的疑似身体虐待患者的流行病学概况，尤其关注骨折的发生情况。
作者回顾了该医院2005年1月至2015年12月期间所有疑似儿童和青少年虐待（AACA）的报告。这些报告按月份和年份进行评估和分类。对发生骨折的身体虐待受害者的特征进行了研究。对有X光片的患者的骨折特征进行了评估。
在3125份报告中，500份被归类为身体伤害；其中63例有骨折。观察到报告数量呈逐年递增趋势。至于年龄组，50名患者（80.6%）年龄在3岁及以下，36名（58%）年龄在1岁及以下。大多数为男性（60%），可能的攻击者主要是母亲单独作案以及父母双方（各占27.5%）。在30例有影像资料的患者中，长骨（股骨、胫骨和肱骨）骨折占主导（71%），同时还有单一骨折线（74%）、骨干部位（73%）以及横行骨折线（57%）。骨折病例中有2例死亡（3%）。
所有骨科医生都应警惕3岁以下有外伤的儿童疑似AACA情况，即使没有典型的虐待迹象。
