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.

Introduction: Chronic Achilles tendon injuries require surgical treatment to improve tendon function. The minimally invasive technique described in this study reduces damage to the fascia and rigid fixation. Objective: To evaluate the clinical and functional outcomes of the reported technique using functional tests, anthropometric measurements and questionnaires. Methods: We evaluated 13 patients who underwent surgical treatment using the minimally invasive technique from 2013 to 2017, after at least 12 months of postoperative follow-up. The patients were subjected to the straight leg raise test to evaluate strength function; we measured the calf circumference and the tibiotarsal angle, and the Achilles Tendon Total Rupture Score (ATRS) and visual analog scale (VAS) were administered. We used parametric tests for statistical analysis. Results: We obtained a 15.4% complication rate (2 patients). We observed differences between healthy and treated limbs when assessing the tibiotarsal angle (a 20% loss of ankle length) and the leg circumference (a 3% decrease in linear measurement). We observed a 36% loss of muscle stretch in functional tests. Conversely, we observed excellent results in the subjective functional assessment using the ATRS (a mean of 82.8 points and a median of 98 points). Conclusion: Surgical treatment of chronic Achilles tendon injuries using the minimally invasive reconstruction technique is associated with an important postoperative objective functional loss. However, this functional loss is not correlated with subjective outcomes assessed using questionnaires in the postoperative follow-up of this technique, which indicates satisfaction and subjective functionality.