To cite this article: Hüseyin Sina COSKUN, Mirac Baris USTA, Ferhat SAY, Abdurrahman Murat YILDIRIM. Factors affecting post-traumatic stress disorder in children with orthopedic injury. J Clin Invest Surg. 2020; 5(1): 24-28. doi: 10.25083/2559.5555/5.1/24.28 Journal of Clinical and Investigative Surgery https://doi.org/10.25083/2559-5555 https://proscholar.org/jcis/ ISSN: 2559-5555 Factors affecting post-traumatic stress disorder in children with orthopedic injury Hüseyin Sina COSKUN 1 , Mirac Baris USTA 2 , Ferhat SAY 1 , Abdurrahman Murat YILDIRIM 3 1 ONDOKUZ MAYIS UNIVERSITY FACULTY OF MEDICINE-SAMSUN, DEPARTMENT OF ORTHOPEDICS AND TRAUMATOLOGY, TURKEY 2 ONDOKUZ MAYIS UNIVERSITY SCHOOL OF MEDICINE-SAMSUN, DEPARTMENT OF CHILD AND ADOLESCENT PSYCHIATRY, TURKEY 3 ZILE STATE HOSPITAL-TOKAT, TURKEY ABSTRACT Introduction. Symptoms of psychological trauma are known to be seen at varying rates in children following extremity trauma. The treatment methods for paediatric fractures may affect the psychological symptoms experienced after trauma. The aim of this study was to determine post-traumatic stress disorder (PTSD) developing after fracture in paediatric patients and to investigate the fracture-related factors that could affect PTSD. Materials and Methods . The study included a total of 30 patients who presented at the Emergency Department and were diagnosed with an isolated, displaced fracture of any extremity. The patients were grouped according to the fracture localization and the treatment method. At the 1-month follow-up examination, the patients were evaluated by an orthopaedic surgeon and a child psychiatrist. A psychiatric interview was conducted and the PTSD Reaction Index (CPTSD-RI) for children and adolescents was applied. Results. The CPTSD-RI score at the end of one month was determined to be higher for children with a lower extremity fracture compared to those with an upper extremity fracture (p=0.151). No significant difference was determined between the general anaesthesia group and the sedation group (p=0.543). Conclusions. Psychological trauma symptoms generally start immediately after the traumatic event, may last for years if the treatment approach is not suitable and an increase in symptoms may be observed during follow-up. It can be recommended that attention is paid to children and adolescents with fractures, particularly of the lower extremity, in respect of PTSD symptoms. Category: Original Research Article Received: January 18, 2020 Accepted: March 14, 2020 Keywords: PTSD, Traumatic Fracture, Children, General Anaesthesia *Corresponding author: Hüseyin Sina Coskun Ondokuz Mayis University Faculty of Medicine, Department of Orthopedics and Traumatology, Kurupelit-Samsun, Turkey E-mail: sina.coskun@hotmail.com Introduction Although fractures involving the field of orthopaedics and traumatology can be seen at any age, childhood is a period when fractures are often seen. Fractures occurring in childhood do not generally require invasive interventions and are successfully treated with closed reduction methods and a plaster cast [1]. Post-Traumatic Stress Disorder (PTSD) is defined as the development in an individual of psychiatric symptoms including emotional, cognitive, behavioral and social disorders following the experience of a traumatic stress agent. Psychiatric symptoms are known to be seen at varying rates in children following fractures as a result of trauma [2]. The treatment methods for paediatric fractures may affect the psychological symptoms experienced after trauma. The aim of this study was to PTSD developing after fracture in paediatric patients and to investigate the fracture -related factors that could affect PTSD. Materials and Methods Patient Group A total of 56 children presented at the Emergency Department of Ondokuz Mayis University Medical Faculty Hospital with a displaced fracture of any extremity and no additional system injury between March 2014 and March 2015 and were evaluated in respect of suitability for the study. Patients with pathological fractures, small and mid- sized bone fractures, non-displaced fractures, those who required further intervention because of reduction loss during follow-up, and patients with head trauma were excluded from the study. A total of 30 patients were included in the study. In the first examination, the