1 in 5 Limb Fractures in Children Receive Delayed Care

Minority, lower limb injury, no external injury sign, continued extremity use all delay medical care

TUESDAY, Dec. 6 (HealthDay News) -- Approximately one in five children with an accidental extremity fracture receive their first medical evaluation more than eight hours after the injury, according to a study published online Dec. 5 in Pediatrics.

Caitlin Farrell, M.D., from the Children's Hospital of Philadelphia, and colleagues interviewed parents of 206 children (<6 years old) with accidental extremity fractures to describe patient and injury characteristics that influence the time from injury to medical care. The demographic characteristics, and signs, symptoms, location, and severity of the fracture were assessed, and their association with delay (more than eight hours) in seeking medical care was examined.

The investigators found that 69 percent of the children had upper extremity fractures. The first medical evaluation occurred at a median time of one hour, and 21 percent of the children were evaluated at more than eight hours after the injury. After the injury, 91 percent of children cried, and 83 percent were irritable for more than 30 minutes. All parents noted at least one sign or symptom but there was no external sign of injury in 15 percent of children, and 12 percent had normal usage of the injured extremity. Delay in seeking medical care was more likely among minority children, those with lower extremity injuries, those without external signs of injury, and those with continued extremity use (odds ratios, 2.54, 2.23, 3.40, and 3.26, respectively).

"Delay in seeking medical care was associated with more subtle signs of injury; however, delays identified in minority patients are unexplained," the authors write.

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