Ali KARAYAGMURLU, Cem GOKCEN, Mustafa İSİK, Ugur PAMUKCU, Onur Burak DURSUN

Relationship between traumatic orthopedic injuries and attention deficit hyperactivity disorder symptoms in children

Traumatic injury is an important cause of department of orthopedics and traumatology in children. Attention deficit hyperactivity disorder (ADHD) has been identified as a potential risk factor that may contribute to the incidence of traumatic injuries. The aim of this study was to evaluate the relationship between traumatic orthopedic injuries and ADHD symptoms in children. A prospective-study approach was used to conduct the study. Ninety-two pediatric patients admitted to the department of orthopedics and traumatology of a university hospital aged between 4 and 18 years were included. The control group consisted of 60 age- and gender-matched children. Conner’s parent Rating Scale (CPRS) were used to evaluate the ADHD symptoms. CPRS impulsivity/hyperactivity subscale score was significantly higher in the study group than in the control group (p < 0.05). Furthermore, analysis of the study group showed that the subscale scores of both scales in the subgroup with a history of repetitive injuries were significantly higher than those of the subgroup without a history of repetitive injuries (p < 0.05). Patients admitted to the orthopedics outpatient clinic for traumatic injuries had a higher number of ADHD symptoms than those who did not have traumatic injuries. These findings suggest that children who had traumatic injuries have more hyperactivity symptoms than without traumatic injuries. Psychiatric consultation for ADHD should be considered for patients admitted to clinics with similar injuries, especially those who have a history of repetitive injuries

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1. Mytton JA, Towner EM, Powell J, et al. Taking the long view: a systematic review reporting long-term perspectives on child unintentional injury. Inj Prev. 2012;18:334-42.

2. Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164:942-8.

3. Swensen A, Birnbaum HG, Ben Hamadi R, et al. Incidence and costs of accidents among attention-deficit/hyperactivity disorder patients. J Adolesc Health. 2004;35:346 e1-9.

4. Fritz KM, Butz C. Attention Deficit/Hyperactivity Disorder and pediatric burn injury: important considerations regarding premorbid risk. Curr Opin Pediatr. 2007;19:565-9.

5. Shilon Y, Pollak Y, Aran A, et al. Accidental injuries are more common in children with attention deficit hyperactivity disorder compared with their non-affected siblings. Child Care Health Dev. 2012;38:366-70.

6. DiScala C, Lescohier I, Barthel M, et al. Injuries to children with attention deficit hyperactivity disorder. Pediatrics. 1998;102:1415-21.

7. Marcus SC, Wan GJ, Zhang HF, et al. Injury among stimulant-treated youth with ADHD. J Atten Disord. 2008;12:64-9.

8. Brehaut JC, Miller A, Raina P, et al. Childhood behavior disorders and injuries among children and youth: a population-based study. Pediatrics. 2003;111:262-9.

9. Pastor PN, Reuben CA. Identified attention-deficit/hyperactivity disorder and medically attended, nonfatal injuries: US school-age children, 1997-2002. Ambul Pediatr. 2006;6:38-44.

10. Fliers E, Rommelse N, Vermeulen SH, et al. Motor coordination problems in children and adolescents with ADHD rated by parents and teachers: effects of age and gender. J Neural Transm. 2008;115:211-20.

11. Rowe R, Maughan B, Goodman R. Childhood psychiatric disorder and unintentional injury: findings from a national cohort study. J Pediatr Psychol. 2004;29:119-30.

12. Celenk F, Gokcen C, Celenk N, et al. Association between the self-insertion of nasal and aural foreign bodies and attention-deficit/hyperactivity disorder in children. Int J Pediatr Otorhinolaryngol. 2013;77:1291-4.

13. Badger K, Anderson L, Kagan RJ. Attention deficit-hyperactivity disorder in children with burn injuries. J Burn Care Res. 2008;29:724-9.

14. Uslu MM, Uslu R. Extremity fracture characteristics in children with impulsive/hyperactive behavior. Arch Orthop Trauma Surg. 2008;128:417-21.

15. Hailer YD, Nilsson O. Legg-Calve-Perthes disease and the risk of ADHD, depression, and mortality. Acta Orthop. 2014;85:501-5.

16. Conners CK, Sitarenios G, Parker JD, et al. The revised Conners' Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26:257-68.

17. Dereboy C, Senol S, Sener S, et al. Validation of the Turkish versions of the short-form Conners' teacher and parent rating scales. Turk Psikiyatri Derg. 2007;18:48-58.

18. Ertan C, Ozcan OO, Pepele MS. Paediatric trauma patients and attention deficit hyperactivity disorder: correlation and significance. Emerg Med J. 2012;29:911-4.

19. Sevimli R, Ceylan MF, Yıldırım E, et al. Is reassessment of radiographs taken from pediatric patients useful for detecting unrecognised hip dysplasia? Eastern J Med. 22:180-3.

20. Karayagmurlu A, Karayagmurlu E, Gokcen C. Osteogenesis imperfecta and attention deficit hyperactivity disorder: A rare combination. Medicine. 2018;7:232-4.

21. Schwebel DC, Roth DL, Elliott MN, et al. Association of externalizing behavior disorder symptoms and injury among fifth graders. Acad Pediatr. 2011;11:427-31.

22. Bruce B, Kirkland S, Waschbusch D. Re: The relationship between childhood behaviour disorders and unintentional injury events. Paediatr Child Health. 2008;13:128.

23. Ozer K, Gillani S, Williams A, et al. Psychiatric risk factors in pediatric hand fractures. J Pediatr Orthop. 2010;30:324-7.

24. Man KK, Chan EW, Coghill D, et al. Methylphenidate and the risk of trauma. Pediatrics. 2015;135:40-8.

25. Chen VC, Yang YH, Liao YT, et al. The association between methylphenidate treatment and the risk for fracture among young ADHD patients: A nationwide population-based study in Taiwan. PLoS One. 2017;12:e0173762.

26. Ersan EE, Dogan O, Dogan S, et al. The distribution of symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder in school age children in Turkey. Eur Child Adolesc Psychiatry. 2004;13:354-61.

27. Hoare P, Beattie T. Children with attention deficit hyperactivity disorder and attendance at hospital. Eur J Emerg Med. 2003;10:98-100.