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Therapy preference of 131 parents confronted with a pediatric femoral fracture
Christoph Arneitz1,2, Istvan Szilagyi1, Bianca Lehner1
1Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
Insights
Most parents of toddlers with femoral fractures prefer surgical treatment, citing faster recovery and better outcomes. Stress and self-employment influenced decisions toward conservative care.
Area of Science:
- Pediatric Orthopedics
- Trauma Management
- Parental Decision-Making
Background:
- Femoral fractures in children aged 3-5 years present complex management challenges.
- Parental attitudes towards treatment options for pediatric femoral shaft fractures are not well understood.
Purpose of the Study:
- To assess parental preferences for treating hypothetical femoral fractures in toddlers (12-36 months).
- To identify factors influencing parental treatment decisions.
Main Methods:
- Survey of 131 parents regarding treatment preferences (conservative vs. surgical).
- Data collection on parental demographics, medical background, education, profession, and personality traits (Freiburg Personality Inventory-Revised).
Main Results:
- 88.5% of parents preferred surgical treatment for pediatric femoral fractures.
- Key reasons for preferring surgery included faster recovery, shorter hospital stays, and reduced long-term complications.
- Parental stress and self-employment status significantly influenced a preference for conservative treatment.
Conclusions:
- The majority of parents favor surgical intervention for pediatric femoral fractures, aligning with current European trauma center trends.
- Elastic stable intramedullary nailing (ESIN) is a commonly preferred surgical method.
- Understanding parental factors is crucial for effective communication and shared decision-making in pediatric fracture management.
Background:
The management of femoral fractures in children between 3 and 5 years of age is still vividly debated. Therefore, we aimed to assess the basic attitude of parents if confronted with a hypothetical femoral fracture of their toddler.
Materials And Methods:
Parents of children aged between 12 and 36 months were asked for their preference after receiving detailed information on conservative and surgical treatment of femoral shaft fractures. Furthermore, we obtained information regarding the parents' gender, marital status, medical background, highest level of education and profession in a leading or non-leading position and if any of their children already had undergone any operations. The Freiburg Personality Inventory (FPI-R) questionnaire was used to assess parents' personality traits.
Results:
In total, 131 participants were included in this study. The vast majority (n = 116, 88.5%) preferred surgical treatment. The most frequently mentioned reasons for this decision were lack of acceptance, followed by faster reconvalescence, shorter hospital stay, less deformity or growth disorders and less stress on the child. The only reason stated against surgical treatment was the need of general anesthesia. A significantly higher rate of conservative procedures was noticed in self-employed participants and stress was found to significantly influence the treatment decision of the parents toward conservative treatment.
Conclusion:
The majority of parents confronted with a hypothetical femoral fracture of their child questioned in this study opted for a surgical approach with elastic stable intramedullary nailing (ESIN). This corresponds with trends toward surgery in these cases in major trauma centers in Europe.
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