Children With High or Low Energy Trauma May Suffer From Post-Traumatic Stress Disorder

SAN ANTONIO — Children with either high or low energy trauma may
post-traumatic stress disorder, according to a study
presented at the Orthopaedic Trauma Association 27th Annual Meeting.

“The purpose of our study was to evaluate high-energy pediatric
trauma patients to determine prevalence of PTSD compared to children who
sustained an isolated low-energy upper extremity frature treated
non-operatively,” Meagan Wallace, MD, said.

Wallace and her team hypothesized that children with high-energy trauma
would have significantly higher rates of post-traumatic stress disorder (PTSD)
than pediatric patients with low-energy trauma and that parents’ stress
would be related to PTSD in their children.

Wallace and her colleagues conducted a prospective study of 76 children,
56 males and 20 females, aged eight to 18 who experienced traumatic injury or
sustained isolated upper extremity injuries at least three months before

“Our exclusion criteria were any child with a psychological
disorder, a traumatic brain injury with a Glasgow Coma Scale <15 or non-English speaking,” Wallace said.

Of the children, 32 had surgery in the trauma group and 10 had more than
one surgery. No patients in the isolated group underwent surgery.

The investigators collected demographic data on the patients’
school and extracurricular activities. They measured outcomes using the Child
PTSD Symptom Scale (CPSS) and the Parent Stress Index (PSI).

The team found that 33% of the total patients suffered from PTSD, 24% of
the trauma group and 9% of the isolated group. Parents’ stress was not
found to cause PTSD in their children.

“One thing that we did find was that involvement in music was
significant in that patients that were involved in music as an extracurricular
activity had lower rates of PTSD,” Wallace said.

The study was limited by the small sample size. The researchers plan to
conduct a larger prospective study in the future, according to Wallace.

“We need to have a awareness of PTSD and we need to have a high
index of suspicion in all pediatric patients regardless of the energy
associated with the trauma,” Wallace said. — Renee Blisard

For more information:

  • Wallace M, Puryear A, Cannada LK. A prospective evaluation of
    posttraumatic stress disorder and parent stress in children exposed to
    orthopaedic trauma. Paper #67. Presented at the Orthopaedic Trauma Association
    27th Annual Meeting. Oct. 12-15. San Antonio.

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