title: Child and family functioning 6 and 12 months after a serious pediatric fracture.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA. tstancin@metrohealth.org
authors.forename: T
authors.initials: T
authors.lastname: Stancin
authors.forename: A S
authors.initials: AS
authors.lastname: Kaugars
authors.forename: G H
authors.initials: GH
authors.lastname: Thompson
authors.forename: H G
authors.initials: HG
authors.lastname: Taylor
authors.forename: K O
authors.initials: KO
authors.lastname: Yeates
authors.forename: S L
authors.initials: SL
authors.lastname: Wade
authors.forename: D
authors.initials: D
authors.lastname: Drotar
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D017281:Cost of Illness; D005195:Family Relations; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000523:psychology* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007103:Immobilization; D008297:Male; D011446:Prospective Studies; D012803:Sick Role; D018434:Sickness Impact Profile; D016896:Treatment Outcome