Factors affecting post-traumatic stress disorder in children with orthopedic injury

Introduction. Symptoms of psychological trauma are known to be seen at varying rates in children following extremity trauma. The treatment methods for paediatric fractures may affect the psychological symptoms experienced after trauma. The aim of this study was to determine post-traumatic stress disorder (PTSD) developing after fracture in paediatric patients and to investigate the fracture-related factors that could affect PTSD. Materials and Methods. The study included a total of 30 patients who presented at the Emergency Department and were diagnosed with an isolated, displaced fracture of any extremity. The patients were grouped according to the fracture localization and the treatment method. At the 1-month follow-up examination, the patients were evaluated by an orthopaedic surgeon and a child psychiatrist. A psychiatric interview was conducted and the PTSD Reaction Index (CPTSD-RI) for children and adolescents was applied. Results. The CPTSD-RI score at the end of one month was determined to be higher for children with a lower extremity fracture compared to those with an upper extremity fracture (p=0.151). No significant difference was determined between the general anaesthesia group and the sedation group (p=0.543). Conclusions. Psychological trauma symptoms generally start immediately after the traumatic event, may last for years if the treatment approach is not suitable and an increase in symptoms may be observed during follow-up. It can be recommended that attention is paid to children and adolescents with fractures, particularly of the lower extremity, in respect of PTSD symptoms.