title: Acute psychosocial impact of pediatric orthopedic trauma with and without accompanying brain injuries.
abstract: BACKGROUND
  The acute psychosocial effects of orthopedic injuries on children and their families are poorly understood. Previous studies have relied on retrospective reports or failed to take into account accompanying brain injuries. The purpose of the present study was to examine prospectively the psychosocial impact of pediatric orthopedic traumatic fractures with and without accompanying brain injuries.
  
  
  METHODS
  Participants were 108 children 6 to 12 years old with orthopedic injuries requiring hospitalization: group 1 (n=80) had fractures only, group 2 (n=28) also had moderate or severe brain injuries. Using standardized measures and parent interviews, we obtained preinjury estimates of family functioning and child behavior problems and postinjury measures of parental distress, family stresses, and child behavior.
  
  
  RESULTS
  Parents reported significant clinical distress (35% in group 1, 57% in group 2), family burdens (group 2 > group 1), and child behavioral changes (41% in group 1, 89% in group 2). Multiple regression analyses indicated that preinjury family status and brain injuries predicted postinjury parental and family distress.
  
  
  CONCLUSIONS
  Pediatric orthopedic injuries have greater social effects on children with accompanying brain injuries and poorer preinjury family functioning.
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA. tstancin@metrohealth.org
authors.forename: T
authors.initials: T
authors.lastname: Stancin
authors.forename: H G
authors.initials: HG
authors.lastname: Taylor
authors.forename: G H
authors.initials: GH
authors.lastname: Thompson
authors.forename: S
authors.initials: S
authors.lastname: Wade
authors.forename: D
authors.initials: D
authors.lastname: Drotar
authors.forename: K O
authors.initials: KO
authors.lastname: Yeates
mesh_terms: D000223:Adaptation, Psychological; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology*; D002648:Child; D002652:Child Behavior; D005190:Family / Q000523:psychology*; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000523:psychology*; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D013315:Stress, Psychological / Q000209:etiology*