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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.
摘要：
目的描述巴西南部一家儿科医院与骨折有关的儿童虐待的可疑/确诊病例。方法研究2016年1月至2020年12月的法定疾病通知和受害者病历信息系统。与受害者相关的变量，肇事者,虐待的类型，骨折的存在，并对其解剖位置和死亡进行了评估。进行Logistic回归以确定骨折相关变量，根据性别和年龄进行调整。结果以比值比及其各自的95%置信区间表示。它被认为是显著的p<0.05。结果276例,73名婴儿(26.4%)，男性占主导地位（151，54.7%），与作者的虐待亲属（245，96，0％），85（31.5％），他们表现出骨折，5人死亡(1.9%)。与骨折相关的因素：受害者的年龄（小于2岁;n=82;或2.48;95％CI：1.45-4.25），涉及两个以上的侵略者（n=144；或2.09；95％CI：1.16-3.75），媒介是交通/汽车事故，（n=52；或2.65；95%CI：1.04-6.75），咨询骨科医生（n=91；或6.77/95%CI：3.66-12.51），以及是否需要手术干预（n=15；OR36.72；95％CI：8.22-164.03）。结论怀疑的重要性，早期识别侵略，并强调正确完成激活权利保障制度和驱逐侵略者的通知。
