Child and family functioning 6 and 12 months after a serious pediatric fracture

Background: Previous findings indicate that pediatric fractures can have ad verse consequences for child adjustment and family functioning immediately after injury. However, longer term effects of the fractures are unknown. Th e purposes of the present prospective study were to examine the child and f amily outcomes of pediatric traumatic fractures at 6 months and 1 year afte r injury, and to identify injury and treatment factors associated with thes e outcomes. Methods: We evaluated 57 children 6 to 12 years of age with traumatic fract ures requiring hospitalization. Using standardized measures and parent inte rview, we obtained measures of pre- and postinjury child and family functio ning. 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 fami lies across all three assessment points. Children with fracture interventio ns that involved prolonged immobilization had more functional limitations a t 6 months than children who were ambulatory. Family burden was higher at 1 month for the immobilized children, but not at later follow-up, Conclusion: some children and families experience adverse effects during th e year after a serious pediatric fracture, especially if sustained in a low er extremity, Fracture stabilization that allows for greater ambulation may offer some benefits related to functional outcomes and family impact.