ObjectiveThis study evaluated the pelvic ring fractures and injuries in patients admitted to and treated at this ward between August, 2012 and January, 2014.Methods66 patients were submitted to treatment protocols according to their age, gender, skin color, injury mechanism, location of the trauma, classification of their injuries, emergency intervention, associated injuries, injured side of the body, treatment, and mortality. The most relevant data were classified according to statistic procedures, such as Goodman's association test. Measures were compared with Student's t-test and analysis of variance associated with Tukey's multiple comparison test.ResultsThe mean age was 47 years; white race and male gender were most common. Car or truck accident was the most common cause of injuries, which occurred mainly in urban sites. Type A injuries were the most frequent. 16.6% of the cases were submitted to emergency surgery. 42.4% displayed associated injuries. The right side of the body was the most commonly affected side. Non-invasive treatment was most commonly used. Death was the outcome in 3% of the cases, associated to high-energy trauma.ConclusionsPelvic ring fractures and injuries are more often verified among males. In general and among younger individuals, traffic accidents are the most common cause of the injury, while among the elderly, ordinary falls are the most commonly verified cause. The majority of those injuries are suffered in urban areas. Type A fractures are more frequent. The majority of cases do not require emergency intervention nor do they feature associated injuries. Non-invasive treatment is most common and death outcomes are associated to high-energy traumas with severe injuries.

Introduction: Accidents caused by fish are common in inland fishing communities in Brazil, being work-related injuries in the majority of cases. These populations have no information on the mechanisms of trauma or envenoming. Methods: Through a questionnaire administered to fishermen, we obtained clinical and epidemiological data on accidents in Rosana, Pontal do Paranapanema, State of São Paulo, Brazil. These data were analyzed and converted into an easily understood prevention and treatment program for the colony. Results: Thirty-nine fishermen replied to the survey. All of the patients had been hurt by fish. Of those mentioned, the yellow catfish (Pimelodus maculatus) was the main fish species associated with injuries, but others also caused trauma to the fishermen. Six fishermen had been envenomed by stingrays. Pain and ulcers were the main symptoms and were described as intolerable. Approximately half of those injured were treated using traditional folk remedies. Conclusions: The fishermen suffered multiple accidents with catfish, which are venomous and cause intense pain, as well as trauma due to other fish, such as surubins, traíras, freshwater croakers, and piranhas. Approximately 16% of those interviewed presented with envenomation from stingrays. Our data and previous experience in the area led to the creation of a pamphlet with clear language that can effectively help fishermen in the region, an area in need of health services and disease prevention. This initiative also applies to the whole La Plata River basin, which has similar fauna.

Em poucas palavras posso dizer que aprendi coisas que vão além da Medicina, Ortopedia, Cirurgia de Coluna, e digo que esses ensinamentos foram muito mais importantes do que o conhecimento puramente técnico. Algumas qualidades facilmente observadas são sua atenção e cuidado com os pacientes e àquela busca incessante pela excelência na profissão. Tais características não são somente elogios, uma vez que sem elas seria pouco provável que estaria na posição em que se encontra. Agradeço também a oportunidade de completar esta dissertação, pelo tempo gasto nela e em reuniões, por compreender as dificuldades que eu como aluno de mestrado poderia apresentar, pela paciência em ajudar a resolver os problemas que encontrei durante o trajeto e especialmente por muitas vezes fazer mais do que simplesmente orientar, tendo uma postura muito ativa para a conclusão do trabalho. Ao Professor Helton Luiz Aparecido Defino e família, Agradeço ao Professor Helton e sua família por esses dois anos de amizade e ensinamentos. Não posso deixar de comentar a grande oportunidade que tive de ouvir as suas muitas histórias de vida e entender que não existe caminho fácil para o sucesso além de vivenciar a luta diária que enfrenta para manter um trabalho de excelência no Hospital das Clínicas. De minha parte foi um grande prazer e uma excelente experiência ter trabalhado por 2 anos ao lado de uma pessoa bastante sábia. Agradecimentos AGRADECIMENTOS Aos meus amigos e pessoas que me apoiaram. A amiga Luciana Mijoler pela dedicação e comprometimento na realização dos exames, contribuindo diretamente para a realização deste trabalho. À Rita Cossalter pela ajuda e dedicação nesses meus anos de pós graduação. Parabéns por executar com excelência aquilo que faz. Aos amigos Herton Rodrigues Tavares Costa, Narcélio Mendes, Rafael Sugino, Raffaello Miranda e Aniello Savaresse, pela época de Fellow em coluna. Aos meus amigos residentes e ex-residentes da Ortopedia, atuais ou futuros colegas ortopedistas pela amizade, histórias, plantões e risadas. Ao Prof. Dr. Marcello Henrique Nogueira Barbosa, pela ajuda durante os dois anos de residência e também pela ajuda nesta dissertação. Ao Dr. Raphael Pratali, pela idealização e ajuda na realização deste projeto.

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