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CORRELATION BETWEEN FRACTURES AND ABUSE IN CHILDREN: A RETROSPECTIVE ANALYSIS

RELAÇÃO ENTRE FRATURAS E SUSPEITA DE MAUS TRATOS EM CRIANÇAS: UMA ANÁLISE RETROSPECTIVA

ABSTRACT

Objective:

The aim of this work is to provide evidence for the relationship between suspicion and diagnosis of cases of child abuse and fractures, since, in national literature, studies are still scarce on the subject.

Methods:

Retrospective study involving electronic medical records of a public reference hospital, in a city of the state of São Paulo, in a 8-year period (2010 to 2018). Cases involving children up to 12 years of age were selected when notified as abuse and presenting fractures; data were statistically analyzed. Results: Among 83 cases of abuse, 19 patients (20.5%) had 23 different fractures. The victims were mainly boys (68.42%) with a mean age of 5 years old, who suffered physical aggression (79%). The majority had no identified aggressor (52%) and 21% were related to the mother. The fracture patterns found involved, mostly, skull fractures (43.48%) and diaphysary fractures (34.78%). Seven patients (30.43%) had other associated lesions and four patients died (21%).

Conclusion:

Despite the number of cases, it was possible to identify relevant characteristics and patterns. These data indicate that the diagnosis is underestimated and show small epidemiological differences compared with international literature. Level of Evidence II, Retrospective study.

Keywords:
Child abuse; Aggression; Bone Fractures; Child

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