Children with fractures show higher levels of impulsive-hyperactive behavior.

Children with fractures have been reported to have impulsive-hyperactive behavior problems although whether they exhibited such behavior more often than children with other orthopaedic conditions is unknown. We investigated whether impulsivity-hyperactivity was more prominent in children with extremity fractures than in children with orthopaedic conditions not involving a fracture. From outpatient clinical intakes, we recruited 39 consecutive children with extremity fractures and 33 children with orthopaedic conditions not involving a fracture. We used the Conners' Parent Rating Scale to detect behavioral symptoms in children with and without extremity fractures. Children who were treated for extremity fractures had higher mean scores for impulsivity-hyperactivity than those treated for nontrauma-related reasons. Additionally, more children in the fracture group reached impulsive-hyperactive behavior scores high enough to warrant additional psychiatric evaluation. In terms of injury prevention, the orthopaedic surgeon should be familiar with problem behaviors of children, particularly impulsivity and hyperactivity, to be able to make appropriate referrals for psychiatric evaluation and treatment.