Glenn Keays, Social and Preventive Medecine, University of Montreal, C.P. 6128, Succ. Centre-ville, Montreal, QC H3C 3J7, Canada, 514-523-2360, gl.keays@sympatico.ca, Bonnie Swaine, PHD, Professeure agrégée, Programme de physiothérapie, University of Montreal, C.P. 6128, Succ. Centre-ville, Montreal, PE H3C 3J7, Canada, and Debbie Feldman, PHD, Faculty of medecine, University of Montreal, C.P. 6128, Succ. Centre-ville, Montreal, QC H3C 3J7, Canada.

PURPOSE: The risk of a second unintentional injury among children and adolescents may be influenced by the type of the first injury. This study sought to determine the risk of subsequent injury among children who sought care for a fractured limb as compared to those who consulted for a soft tissue injury to a limb.

METHODS: Using a national database of childhood injury, we identified 4287 persons aged 2-18 years who presented to the pediatric emergency departments in Montreal for an upper or lower limb injury. Telephone interviews were conducted with their parents 6 months following the index injury, to ascertain possible subsequent injuries. Multiple logistic regression was used to calculate estimated risk of subsequent injury, by type of first injury, adjusted for age, gender, body part injured, and socioeconomic status.

RESULTS: Among the 2376 persons who had an index fracture and the 1911 persons who had a soft tissue injury, 316 and 342, respectively had a subsequent injury. Subjects with an index fracture were at lower risk for subsequent injury than those with a soft tissue injury (adjusted OR: 0.68, 95 %CI: 0.56-0.82), as were younger children (OR: 0.67, 95% CI: 0.51-0.88).

CONCLUSION: Having a fracture may be protective of subsequent injury in children and adolescents. We hypothesize that those who had fractures may have learned to avoid future risks or may have been offered better medical advice. Improving the provision of advice for those consulting with non-fracture injuries may be warranted.

Learning Objectives:

• Participants taking part in this session will explore a relatively new risk factor in the epidemiology of children's unintentional injuries having to do with the effect that the severity of past injury episodes have on subsequent injury. Through this presentation, the audience will be asked to revisit conventional risk factors such as age, sex and socioeconomic status in view of severe past injuries affecting outcome and occurrence of future injuries.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.