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ObjectiveThis study evaluated the epidemiological profile of patients with suspected physical abuse, especially regarding the occurrence of fractures, treated in a referral hospital.MethodsThe 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.ResultsOf 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%).ConclusionAll orthopedists should be alert to suspected AACA in children with trauma below the age of three, even without classic signs of abuse.

RESUMOA hemofilia é uma doença de herança genética ligada ao cromossomo X. A principal alteração dessa patologia afeta os mecanismos de coagulação. As articulações mais acometidas são os joelhos, cotovelos e tornozelos. As manifestações clínicas incluem dor, sangramento articular e limitação do movimento. O diagnóstico leva em consideração o quadro clínico e exames de imagem. Neste artigo, apresentamos o caso de um paciente com restrição das atividades diárias e perda da qualidade de vida devido à artropatia hemofílica no tornozelo direito. Após a realização da artroplastia total da articulação afetada, o paciente evoluiu com melhora dos parâmetros pré-operatórios. Nível V de Evidência; Opinião de Especialista.Descritores: Tornozelo; Hemofilia; Hemartrose/cirurgia; Artroplastia de substituição do tornozelo. AbStRActHemophilia is a genetically inherited disease linked to the X chromosome. The main alteration of this pathology affects the coagulation mechanisms. The most affected joints are the knees, elbows and ankles. Clinical manifestations include pain, joint bleeding and limited movement. The diagnosis takes into account the clinical picture and imaging tests. In this article, we present the case of a patient with restricted performance of activities of daily living and loss of quality of life due to hemophilic arthropathy in the right ankle. After total joint arthroplasty of the affected joint, there was improvement in the preoperative parameters of the patient. Level V of Evidence; Expert Opinion.Como citar esse artigo: Silva JLV, Pacheco LRL, Nakahashi ER, Picini M. Artroplastia total do tornozelo (ATT) em paciente hemofílico: relato de caso. Sci J Foot Ankle. 2018;12(1):72-6.