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Child and family functioning 6 and 12 months after a serious pediatric fracture
T Stancin1, A S Kaugars, G H Thompson
1Departments of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA. tstancin@metrohealth.org
Insights
Pediatric fractures can impact child adjustment and family life for up to a year, particularly lower extremity fractures. Early mobility after fracture may improve functional outcomes and reduce family stress.
Area of Science:
- Pediatric Orthopedics
- Child Psychology
- Family Studies
Background:
- Pediatric fractures can negatively affect child adjustment and family functioning post-injury.
- Long-term effects of pediatric traumatic fractures on children and families remain under-researched.
- Understanding these long-term impacts is crucial for comprehensive care.
Purpose of the Study:
- To prospectively examine child and family outcomes 6 months and 1 year after pediatric traumatic fractures.
- To identify injury-related and treatment-related factors associated with these outcomes.
- To provide insights into the recovery trajectory and support needs.
Main Methods:
- Prospective evaluation of 57 children (6-12 years) with traumatic fractures requiring hospitalization.
- Utilized standardized measures and parent interviews to assess pre- and post-injury functioning.
- Collected data at multiple time points to track changes over time.
Main Results:
- While most outcomes improved by 1 year, functional limitations and family stress persisted up to 6 months.
- Lower extremity fractures demonstrated a more significant negative impact on families.
- Prolonged immobilization led to greater functional limitations at 6 months compared to ambulatory children.
Conclusions:
- Adverse effects can occur in children and families during the year following a serious pediatric fracture, especially lower extremity injuries.
- Fracture stabilization techniques allowing for increased ambulation may positively influence functional recovery and family well-being.
- Further research into optimizing treatment and support is warranted.
Background:
Previous findings indicate that pediatric fractures can have adverse consequences for child adjustment and family functioning immediately after injury. However, longer term effects of the fractures are unknown. The purposes of the present prospective study were to examine the child and family outcomes of pediatric traumatic fractures at 6 months and 1 year after injury, and to identify injury and treatment factors associated with these outcomes.
Methods:
We evaluated 57 children 6 to 12 years of age with traumatic fractures requiring hospitalization. Using standardized measures and parent interview, we obtained measures of pre- and postinjury child and family functioning.
Results:
Although outcomes were primarily positive at 1 year after injury, child functional limitations and family stress were observed up to 6 months after injury. Lower extremity fractures had a more negative impact on families across all three assessment points. Children with fracture interventions that involved prolonged immobilization had more functional limitations at 6 months than children who were ambulatory. Family burden was higher at 1 month for the immobilized children, but not at later follow-up.
Conclusion:
Some children and families experience adverse effects during the year after a serious pediatric fracture, especially if sustained in a lower extremity. Fracture stabilization that allows for greater ambulation may offer some benefits related to functional outcomes and family impact.