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Collegium antropologicum, Vol.31 No.2 April 2007. -

Self-esteem involves the evaluative and affective dimensions of self-concept. It could be influenced by stress situations

such as diseases or injuries, especially in the period of puberty and adolescence. The aim of this study was to establish the

influence of isolated long tubular bone limbs’ fractures in children and adolescents and type of its treatment conservative

or active surgical treatment-various techniques on self-esteem of patients, as well as to establish relationships between

self-esteem, depression, anxiety and perception of the social support in the mentioned patients. This prospective

clinical trial comprehends 135 patients, 94 male and 41 female, aged 10 to 18, treated for the mentioned fractures in the

period from October 2003 until March 2005 in Departments for Pediatric Surgery of three hospitals: the Clinical Hospital

Center in Rijeka 88.8% patients, the Clinical Children’s Hospital in Zagreb 9.7%, both in Croatia, and 1.5% of the

patients in the Clinical Hospital in Mostar Bosnia and Herzegovina. 53.3% of the patients were treated conservatively,

29.6% of them underwent the elastic stable intramedullary nailing ESIN, while the remaining 17.1% of the patients

were treated with other surgical techniques AO-plates or Kirschner-wire ostheosyntheses. The basic methods of work

were self-reported questionnaires: Rosenberg Self-esteem Scale RSS, to establish the degree of self-esteem; Children Depression

Inventory CDI, to establish existence and degree of depression; Spielberg State Trait Anxiety Inventory STAI-

form STAI2, to establish general anxiety; and Test of Perception of Social Support TPSS. RSS, CDI and STAI2 were

administered twice to the patients: at baseline and after 6 months of the trauma, whereas TPSS once, after 1 month of the

trauma. Our results point at an decreased self-esteem followed by increased depression and increased general anxiety indicators

in all patients within 1 week of experienced trauma, especially in those who underwent the ESIN method,

whereas after 6 months of the experienced trauma, self-esteem significantly increased and depression and general anxiety

indicators were greatly reduced in all patients. The type of treatment of fractures has no influence on the perception of

the social support. Our results suggest that the ESIN method regardless of its good surgical results and advantages in

relation to many other surgical techniques reduces self-esteem more than conservatively treatment of fractures and AOplates

and K-wire ostheosyntheses. At the same time self-esteem has been recuperated faster in patients treated with

ESIN method. Thus, there is no difference in the influence of the type of the treatment of fractures on self-esteem, but in

the dynamics of its recuperation in patients according to type of treatment of fractures. Anyway, from a psychological

point of view, any type of surgical treatment could be additional stressor, so it should be practiced with criticism and according

to the strict surgical indications.

adolescents; children; locomotory trauma; different treatments; self-esteem

Autor: Suzana Jonovska - Tanja Frančišković - Ante Kvesić - Hary Nikolić - Zrinko Brekalo - Eduard Pavlović - Daliborka Dalija Bil



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