Back to 2026 ePosters
Intentional Hand Fractures as a Predictor of Future Psychiatric Conditions in a Paediatric Population
Olivia Piccolo, MSc, Colton Boudreau, MSc, MD, Todd Dow, MD, Berfin Bati, BSc, Selene Etches, MD, FRCPC; Bezuhly Michael, MD, MSc, FRCS(C)
Dalhousie University, Halifax, NS, Canada
Introduction: Hand fractures are a common presentation to paediatric fracture clinics. There is currently no literature investigating the link between paediatric hand injuries and subsequent presentation to mental health and addictions (MHA) services. This study aimed to assess correlation between hand fracture mechanisms and secondary presentation to MHA services in a paediatric population.
Methods: A retrospective cohort study assessed all patients presenting to a paediatric fracture clinic from 2012 to 2017. Demographics, fracture mechanism, fracture location, and subsequent presentation to MHA services were collected. Stepwise logistic regression models were employed to assess predictors for future presentation to mental health.
Results: Between 2012 and 2017, 1184 patients presented with paediatric hand fractures. Most patients were right-handed (90.8%) with accidental injuries (87.9%). The most common mechanism of injury overall was sports-related (52.4%). Within the cohort, 144 (12.1%) presented with an intentional mechanism of injury. Among these patients, the most common mechanism of injury was punching a solid object (53.5%) or another individual (45.1%). The mean age of patients with accidental mechanisms of injury was 11.8 +/- 3 years, and 14.1 +/- 1.5 years for intentional mechanisms (p<0.001). There was a male predominance in both the accidental (66.2%) and intentional (93.1%) cohorts (p<0.001). A total of 145 patients (12.2%) were assessed by MHA services at some point in their history. There was a significantly higher rate of mental health presentation before or after injury in patients with intentional vs accidental injuries ([n = 60, 41.4%] vs [n = 85, 8.2%], p <0.001), odds ratio of 7.9 (CI 5.3-11.8). There was a relative risk of 5.06 for intentional fractures being assessed by MHA services in the future. The most diagnosed mental health condition was ADHD (56.7%). Logistic regression analysis demonstrated that intentional mechanism of injury was a significant predictor for a future diagnosis of ADHD (p<0.001), Generalized Anxiety Disorder (p=0.022), Major Depressive Disorder (p=0.012), and substance use disorder (p<0.001).
Conclusions: Our data indicates that intentional hand fractures in the paediatric population are a predictable variable for eventual mental health assessment, which suggests consideration for early referral to MHA services when paediatric patients present with intentional hand fractures.
Back to 2026 ePosters
