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ABSTRACT Objective: To assess the frequency of physeal injuries and wrist pain in young competitive gymnasts according to their training characteristics . Methods: This is a cross-sectional study (January-June 2015) of a male gymnastics team in São Paulo, SP, Brazil. Nineteen gymnasts, mean age 13.3 years, were evaluated in three ways: a questionnaire, physical examination and radiographs . Results: On average, they trained since 6 years-old and during hours per week. Eighty-two percent had wrist pain and 65% had wrist physeal injury. The pain was worse in practitioners of (82%) and soil (17%) exercises. A greater frequency of physeal injury was found in those with more years of training and higher weekly working hours, wrist pain was more frequent in those with higher weekly working hours, and a decreased range of motion was observed in those with physeal injury, results statistically significant . Conclusions: We found that 65% of gymnasts had wrist physeal injury and 82% had wrist pain. There were statistically significant relationships between physeal injury and years of training, physeal injury and weekly working hours, pain and weekly working hours, and physeal injury and range of motion. Level of Evidence IV, Case Series.

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OBJECTIVE: The purpose of this study was to assess the importance of pelvic fractures in childhood by analyzing epidemiological characteristics and associated injuries. METHODS: This is a retrospective study performed between 2002 and 2012 at two trauma referral centers in São Paulo. We identified 25 patients aged 16 years old or younger with pelvic fracture. RESULTS: The main mechanism of trauma was traffic accident (80%), followed by fall from height (16%). At hospital admission, 92% had traumatic brain injury and 40% had hemodynamic instability. Besides pelvic fractures, 56% of the children had other associated injuries (genitourinary, abdominal, vascular, chest and neurological), and 79% of them required operative treatment. According to the Torode and Zieg classification, the majority of cases were types III and IV. Seventy-two percent of all pelvic fractures were treated by surgery; 52% involved external fixation and 20% involved open reduction and internal fixation. CONCLUSIONS: The pelvic fractures in childhood can be considered a marker for injury severity, because the associated injuries usually are severe, needing operative treatment and leading to a high mortality rate (12%). Level of Evidence IV, Case Series

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OBJECTIVE: The purpose of this study was to assess the importance of pelvic fractures in childhood by analyzing epidemiological characteristics and associated injuries. METHODS: This is a retrospective study performed between 2002 and 2012 at two trauma referral centers in São Paulo. We identified 25 patients aged 16 years old or younger with pelvic fracture. RESULTS: The main mechanism of trauma was traffic accident (80%), followed by fall from height (16%). At hospital admission, 92% had traumatic brain injury and 40% had hemodynamic instability. Besides pelvic fractures, 56% of the children had other associated injuries (genitourinary, abdominal, vascular, chest and neurological), and 79% of them required operative treatment. According to the Torode and Zieg classification, the majority of cases were types III and IV. Seventy-two percent of all pelvic fractures were treated by surgery; 52% involved external fixation and 20% involved open reduction and internal fixation. CONCLUSIONS: The pelvic fractures in childhood can be considered a marker for injury severity, because the associated injuries usually are severe, needing operative treatment and leading to a high mortality rate (12%). Level of Evidence IV, Case Series.

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OBJECTIVE: To assess the frequency of physeal injuries and wrist pain in young competitive gymnasts according to their training characteristics . METHODS: This is a cross-sectional study (January-June 2015) of a male gymnastics team in São Paulo, SP, Brazil. Nineteen gymnasts, mean age 13.3 years, were evaluated in three ways: a questionnaire, physical examination and radiographs . RESULTS: On average, they trained since 6 years-old and during hours per week. Eighty-two percent had wrist pain and 65% had wrist physeal injury. The pain was worse in practitioners of (82%) and soil (17%) exercises. A greater frequency of physeal injury was found in those with more years of training and higher weekly working hours, wrist pain was more frequent in those with higher weekly working hours, and a decreased range of motion was observed in those with physeal injury, results statistically significant . CONCLUSIONS: We found that 65% of gymnasts had wrist physeal injury and 82% had wrist pain. There were statistically significant relationships between physeal injury and years of training, physeal injury and weekly working hours, pain and weekly working hours, and physeal injury and range of motion. Level of Evidence IV, Case Series.

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Contexto: Os cistos esplênicos não parasitários são eventos raros, muitas vezes assintomáticos e encontradosincidentalmente durante exames de imagem.Descrição do caso: Paciente do sexo feminino, 25 anos, parda, foi atendida pelo Grupo de Fígado e Hipertensão Portalda Faculdade de Ciências Médicas da Santa Casa de São Paulo, e o quadro clínico inicial corroborou com o achadoincidental do cisto. O diagnóstico foi confirmado pela ressonância nuclear magnética de abdome superior e pelo examehistopatológico de fragmento obtido no intraoperatório. O tratamento instituído foi o destelhamento do cisto por viavideolaparoscópica, com a colocação de epíplon no interior do leito cístico.Discussão: A paciente encaixa-se no clássico quadro de achado incidental em exames de imagem, sendo os primeirossintomas inespecíficos. Além disso, este caso se sobressai devido à sua raridade, tanto entre os vistos diariamenteno serviço como nos casos descritos na literatura. Foi optado pelo tratamento videolaparoscópico que apresentouexcelente resultado, com melhora dos sintomas, tempo cirúrgico curto e evitou a esplenectomia total.Conclusões: Os cistos esplênicos são achados incidentais dentro de um quadro clínico assintomático ou inespecífico.Apesar da raridade, devem estar sempre no acervo de conhecimento de todo médico para que a conduta seja adequadae os resultados satisfatórios.

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