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Symptoms and time to medical care in children with accidental extremity fractures

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dc.contributor.author Farrell, C., Rubin, D. M., Downes, K., Dormans, J., & Christian, C. W.
dc.date.accessioned 2014-12-08T19:47:33Z
dc.date.available 2014-12-08T19:47:33Z
dc.date.issued 2012
dc.identifier.citation Farrell, C., Rubin, D. M., Downes, K., Dormans, J., & Christian, C. W. (2012). Symptoms and time to medical care in children with accidental extremity fractures. Pediatrics, 129(1), e128-e133. en_US
dc.identifier.uri http://pediatrics.aappublications.org/content/129/1/e128.long
dc.identifier.uri http://hdl.handle.net/11212/1931
dc.description.abstract Delay in seeking medical care is one criterion used to identify victims of abuse. However, typical symptoms of accidental fractures in young children and the time between injury and the seeking of medical care have not been reported. We describe patient and injury characteristics that influence the time from injury to medical care. Parental interviews were conducted for children <6 years old with accidental extremity fractures. Demographic characteristics, signs and symptoms of the injury, and fracture location and severity were described and examined for their association with a delay (>8 hours) in seeking medical care. Among 206 children, 69% had upper extremity fractures. The median time to the first medical evaluation was 1 hour, but 21% were seen at >8 hours after injury. Although 91% of children cried after the injury, only 83% were irritable for >30 minutes. Parents observed no external sign of injury in 15% of children, and 12% used the injured extremity normally. However, all parents noted at least 1 sign or symptom. Minority children (odds ratio [OR]: 2.54 [95% confidence interval [CI]: 1.18–5.47), those with lower extremity injuries (OR: 2.23 [95% CI: 1.01–4.90]), those without external signs of injury (OR: 3.40 [95% CI: 1.36–8.51]), and those with continued extremity use (OR: 3.26 [95% CI: 1.22–8.76]) were more likely to delay seeking medical care. Although some children did not manifest all expected responses, no child with an accidental fracture was asymptomatic. Delay in seeking medical care was associated with more subtle signs of injury; however, delays identified in minority patients are unexplained en_US
dc.language.iso en_US en_US
dc.publisher Pediatrics en_US
dc.subject child abuse en_US
dc.subject medical care en_US
dc.subject physical abuse en_US
dc.subject extremity fractures en_US
dc.title Symptoms and time to medical care in children with accidental extremity fractures en_US
dc.type Article en_US


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