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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(02): e269-e277
DOI: 10.1055/s-0044-1785466
Artigo Original
Ortopedia Pediátrica

Reports of Maltreatment in a Children's Hospital: Evaluation of the Epidemiological Profile and Its Relationship with the Outcome in Fractures

Article in several languages: português | English
Janaína Romão de Andrade 
1   Hospital Infantil Joana de Gusmão/SES, Florianópolis, SC, Brasil
,
Vanessa Borges Platt 
2   Universidade Federal de Santa Catarina, SC, Brasil
,
Michele Honicky 
2   Universidade Federal de Santa Catarina, SC, Brasil
› Author Affiliations Financial Support The authors state they received no financial support from public, commercial, or non-profit sources.
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Abstract

Objective To describe suspected/confirmed cases of child maltreatment related to fractures in a pediatric hospital in southern Brazil.

Method Study of the Information System of Notifiable Diseases notifications and the victims' medical records between January/2016 and December/2020. Variables related to the victim, the perpetrator, the type of abuse, the presence of fractures, and their anatomical location and death were evaluated. Logistic regression was performed to identify fracture-related variables, adjusted for sex and age. The results were expressed in odds ratios and their respective 95% confidence intervals. It was considered significant p < 0.05.

Results There were 276 cases, 73 infants (26.4%), male predominance (151, 54.7%), with authorship of the mistreatment by relatives (245, 96,0%), 85 (31,5%), they presented fractures, with five deaths (1.9%). Factors related to the presence of fracture: age of the victim (less than two years old; n = 82; or 2.48; 95% CI: 1.45 - 4.25), having more than two aggressors involved (n = 144; or 2.09; 95% CI: 1.16-3.75), the medium being traffic/automobile accident, (n = 52; or 2.65; 95% CI: 1.04–6.75), consult an orthopedist (n = 91; or 6.77 / 95% CI: 3.66–12.51), and the need for surgical intervention (n = 15; OR 36.72; 95% CI: 8.22–164.03).

Conclusions The importance of suspicion, early identification of aggression, and the correct completion of notifications for activating the system of guaranteeing rights and removal of the aggressor was emphasized.

Keywords

child abuse - bone fractures - violence - negligence

Authors' Contribution

Each author contributed individually and significantly to developing this article: JRA, VBP: Study design. JRA: Data collection. JRA, VBP, MH: Data analysis, manuscript writing, manuscript review, and supervision.


Work developed at the Joana De Gusmão Children's Hospital/SES, Florianópolis, SC, Brazil.




Publication History

Received: 04 July 2023

Accepted: 19 September 2023

Article published online:
10 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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