Examining the Relationship Between Preventable Psychiatric Problems and Child Extremity Fractures

Abstract views: 112 / PDF downloads: 117





Extremity fracture, psychopathology, children


Objective: Extremity fractures (EF) are among the most common causes of admission to hospitals in children. We aimed to evaluate children treated for EFs by comparing them with the control group from a psychiatric perspective.

Method: Thirty-six children aged between 3 and 17 years who administered to the Orthopedics and Traumatology clinic due to EF were included in the study. 36 children of similar age and gender with the study group were included as the control group. A child psychiatrist evaluated all children included in the study. A psychiatric diagnosis interview was conducted. The parents filled out the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R:S).

Results: Of the cases in the patient group, 66.7% were male. The ratio of rural residents in the patient group was higher compared to the control group. The most common fracture location was lower extremity (55.6%). The most common cause of the fracture was falling (52.8%). In the patient group, the ratio of the children who had previously experienced fracture was 36.1%. Psychopathology was detected to be at a higher level in the patient group. The most common was Attention Deficiency and Hyperactivity Disorder (ADHD). Children in the patient group scored higher on the CPRS-R:S than the control group.

Conclusion: Children with EF exhibited more impulsive and hyperactive behaviours than controls and had more psychopathology. For this reason, it is essential to evaluate children who apply due to fracture in terms of psychopathology.


Metrics Loading ...


Powell EC, Tanz RR. Adjusting our view of injury risk: the burden of nonfatal injuries in infancy. Pediatrics 2002;110(4):792–796.

Donaldson LJ, Reckless IP, Mindell JS, Shelton NJ. The epidemiology of fractures in England. J Epidemiol Community Health 2008;62:174-180.

Rennie L, Court-Brown CM, Mok JYQ, Beattie TF. The epidemiology of fractures children. Injury 2007; 38, 913–922.

Wilkins KE, Aroojis AJ. Incidence of fractures in children. In: Beaty JH, Kasser JR (eds) Rockwood and Wilkins’ fractures in children. Lippincott, Williams & Wilkins, Philadelphia, 2005:3-18.

Hedström EM, Svensson O, Bergström U, Michno P. Epidemiology of fractures in children and adolescents: Increased incidence over the past decade: A population-based study from northern Sweden. Acta Orthop 2010; 81, 148–153.

ChristoVel KK, Donovan M, Schofer J, Wills K, Lavigne JV. Psychosocial factors in childhood pedestrian injury: a matched case-control study. Pediatrics 1996; 97: 33–42.

Loder RT, Warschausky S, Schwartz EM, Hensinger RN, Greenfield ML. The psychosocial characteristics of children with fractures. J Pediatr Orthop 1995; 15: 41–6.

Brehaut JC, Miller A, Raina P, McGrail KM. Childhood behavior disorders and injuries among children and youth: a population based study. Pediatrics 2003; 111: 262–9.

Ertan C, Ozcan OO, Pepele MS. Paediatric trauma patients and attention deficit hyperactivity disorder: Correlation and significance. Emerg Med J 2012; 29(11):911–4.

Chou IC, Lin CC, Sung FC, Kao CH. Attention-deficit hyperactivity disorder increases risk of bone fracture: a population-based cohort study. Dev Med Child Neurol 2014;56:1111–1116.

Uslu M, Uslu R, Eksioglu F, Ozen NE. Children with fractures show higher levels of impulsive-hyperactive behaviour. Clin Orthop elat Res. 2007; 460:192-195.

Conners CK. Conners’ Rating Scales-Revised. Instruments for use with children and adolescents. Toronto: MHS; 1997.

B. Gokler, F. Unal, B. Pehlivanturk, et al. Schedule for affective disorders and schizophrenia for school age children present and lifetime version: validity and reliability of the Turkish version Turk J Child Adolesc Ment Health, 11 (2004), p. 109.

Kaner S, Buyukozturk Ş, Işeri E. Conners’ Parent Rating Scale-Revised Short: Turkish Stardardization Study. Archives of Neuropsychiatry 2013; 50: 100-109.

Byrne JM, Brewden HN, Beattie T, DeWolfe NA. Risk for injury in preschoolers: relationship to attention deficit hyperactivity disorder. Child Neuropsychol 2003;9:142–151.

DiScala C, Lescohier I, Barthel M, Li G. Injuries to children with attention deficit hyperactivity disorder. Pediatrics 1998;102:1415–421.

Rowe R, Maughan B, Goodman R. Childhood psychiatric disorder and unintentional injury: findings from a national cohort study. J Pediatr Psychol 2004; 29:119–130.

Schwebel DC, Speltz ML, Jones K, Bardina P. Unintentional injury in preschool boys with and without early unset of disruptive behavior. J Pediatr Psychol 2002; 27:727–737.

Lange H., Buse J., Bender S., Siegert J., Knopf H., Roessner V. Accident Proneness in Children and Adolescents Affected by ADHD and the Impact of Medication. J Atten Disord 2012;20(6):501–509.

Clancy TA, Rucklidge JJ, Owen D. Road-crossing safety in virtual reality: a comparison of adolescents with and without ADHD. J Clin Child Adolesc Psychol 2006; 35(2):203–215.

Hoarea P, Beattieb T. Children with attention deficit hyperactivity disorder and attendance at hospital. Eur J Emerg Med 283 2003;10(2):98-100.

Uzun Çiçek A, Sarı SA, Ucuz İ. Attention-Deficit/Hyperactivity Disorder as a Risk Factor for Fractures. Anatol J Family Med 2020;3(3):234–241.

Uslu MM, Uslu R. Extremity fracture characteristics in children with impulsive/hyperactive behavior. Arch Orthop Trauma Surg 2008;128:417.

Mattila VM, Jormanainen V, Sahi T, Pihlajamäki H. An association between socioeconomic, health and health behavioral indicators and fractures in young adult males. Osteoporos Int 2007;18:1609–1615.

Hammig B, Weatherley J. Gender and geographic differences in intentional and unintentional injury mortality among children in Illinois, 1988–1998. Inj Control Saf Promot 2003;10(4):247–50.

Owen PL, Zodet MW, Berdahl T, Dougherty D, McCormick MC, Simpson LA. Annual report on health care for children and youth in the United States: Focus on injury-related emergency department utilization and expenditures. Ambul Pediatr. 2008;8:219–40.

Singh GK, Azuine RE, Siapush M, Kogan MD. All-cause and cause-specific mortality among US youth: Socioeconomic and rural–urban disparities and international patterns. J Urban Health: Bull New York Acad Med. 2012;90(3):388–405.

İnanç DC, Baysal SU, Coşgun L, Taviloglu K, Unuvar E. Preparatory causes of childhood injuries. Turk Pediatr Arsivi 2008;43(3):84–88.

Arunachalam VS, GriYths JC. Fracture recurrence in children. Injury 1975; 7(1):37–40.




How to Cite

Sari, S. A., Pazarci, O., Kilinc, S., & Cicek, A. U. (2022). Examining the Relationship Between Preventable Psychiatric Problems and Child Extremity Fractures. European Journal of Therapeutics, 28(4), 279–284. https://doi.org/10.58600/eurjther-28-4-0087



Original Articles