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

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dc.contributor.authorFarrell, C., Rubin, D. M., Downes, K., Dormans, J., & Christian, C. W.
dc.date.accessioned2014-12-08T19:47:33Z
dc.date.available2014-12-08T19:47:33Z
dc.date.issued2012
dc.description.abstractDelay 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 unexplaineden_US
dc.identifier.citationFarrell, 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.urihttp://pediatrics.aappublications.org/content/129/1/e128.long
dc.identifier.urihttp://hdl.handle.net/11212/1931
dc.language.isoen_USen_US
dc.publisherPediatricsen_US
dc.subjectchild abuseen_US
dc.subjectmedical careen_US
dc.subjectphysical abuseen_US
dc.subjectextremity fracturesen_US
dc.titleSymptoms and time to medical care in children with accidental extremity fracturesen_US
dc.typeArticleen_US

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