Acute psychosocial impact of pediatric orthopedic trauma with and without accompanying brain injuries

Background: The acute psychosocial effects of orthopedic injuries on childr en and their families are poorly understood. Previous studies have relied o n retrospective reports or failed to take into account accompanying brain i njuries. The purpose of the present study was to examine prospectively the psychosocial impact of pediatric orthopedic traumatic fractures with and wi thout accompanying brain injuries. Methods: Participants were 108 children 6 to 12 years old with orthopedic i njuries requiring hospitalization: group 1 (n = 80) had fractures only, gro up 2 (n = 28) also had moderate or severe brain injuries. Using standardize d measures and parent interviews, we obtained preinjury estimates of family functioning and child behavior problems and postinjury measures of parenta l 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 cha nges (41% in group 1, 89% in group 2), Multiple regression analyses indicat ed that preinjury family status and brain injuries predicted postinjury par ental and family distress. Conclusion: Pediatric orthopedic injuries have greater social effects on ch ildren with accompanying brain injuries and poorer preinjury family functio ning.