Related Experiment Video
Updated: Aug 11, 2026
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Outpatient pediatric pain management practices for fractures
Amy L Drendel1, Roger Lyon, Jo Bergholte
1Pediatric Department, Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA. adrendel@mail.mcw.edu
Insights
Most children experience severe pain within 48 hours of a fracture, using pain medication for about 3 days. Functional limitations and missed school/workdays are common for children and caregivers, with ibuprofen and codeine-based acetaminophen being the most frequent pain relievers.
Area of Science:
- Pediatric Orthopedics
- Pain Management
- Pharmacology
Background:
- Pediatric extremity fractures are common injuries.
- Effective pain management is crucial for recovery and minimizing functional deficits.
- Understanding medication use patterns and their impact is essential for optimizing care.
Purpose of the Study:
- To describe the utilization patterns of outpatient pain medication for pediatric fractures.
- To assess the effectiveness of these medications in managing fracture pain.
- To identify associated functional limitations in children and their caregivers.
Main Methods:
- A cross-sectional survey was conducted with caregivers of children treated for isolated extremity fractures.
- Data collection occurred at a pediatric orthopedic clinic during initial follow-up appointments.
- Caregiver responses were analyzed to determine medication use, pain levels, and functional limitations.
Main Results:
- Pain was most severe within the first 48 hours post-injury for 45.3% of children.
- Ibuprofen (43.5%) and acetaminophen with codeine (26.1%) were the most commonly used analgesics.
- Children experienced functional limitations for an average of 2-4 days, with caregivers missing work and children missing school.
Conclusions:
- Children with fractures typically experience peak pain within 48 hours and require analgesia for approximately 3 days.
- Significant functional limitations affect both children and caregivers, impacting daily activities.
- While ibuprofen and acetaminophen with codeine are widely used, no single analgesic demonstrated clear superiority in this study.
Objectives:
Describe the pattern of utilization and effectiveness of outpatient fracture pain medication.
Methods:
A cross-sectional survey of caregivers of children with an isolated extremity fracture at a hospital-based pediatric orthopedic clinic during initial follow-up.
Results:
Surveys were completed by 98 (79.2%) of 125 caregivers. Mean age of children was 9 years (range, 1-18 years). Fracture sites include arm (36%), wrist (24%), hand (6%), leg (14%), ankle (9%), and foot (6%). Pain was reported "worst" at the time of injury in 45.3% patients (95% confidence interval [CI], 35.0%-55.8%) and in the first 48 hours of injury in 30.5% patients (95% CI, 21.5%-40.8%). The most commonly used medications were ibuprofen 43.5% (95% CI, 34.4%-52.5%) and acetaminophen with codeine 26.1% (95% CI, 18.1%-34.1%). Mean duration of medication use was 3.2 days (95% CI, 2.8-3.6 days). The mean duration of functional limitations included 4.2 days (95% CI, 2.8-5.5 days) for playing, 2.6 days (95% CI, 1.7-3.4 days) for performing at school, 2.4 days (95% CI, 1.8-3.0 days) for sleeping, and 2.0 days (95% CI, 1.0-3.0 days) for eating. Mean days of work missed by caregivers was 1.6 (95% CI, 1.1-2.0 days), and days of school missed by children was 2.0 (95% CI, 1.6-2.3 days). Significantly more children with lower extremity fractures had functional limitation (P < 0.05).
Conclusion:
Most children with fractures have the "worst" pain in the first 48 hours after injury and used analgesia for 3 days after injury. There are noteworthy functional limitations for both children and their caregivers. Ibuprofen and acetaminophen with codeine are the analgesics most commonly used, with no clear superiority.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: