Uygar Daşar1, Ozan Altun2, Yılmaz Ergişi1, Osman Arıkan1, Erdi Özdemir1

1Department of Orthopedics and Traumatology, Karabük Training and Research Hospital, Karabük, Türkiye
2Department of Orthopedics and Traumatology, Çankırı State Hospital, Çankırı, Türkiye

Keywords: Anxiety, cast removal, headphone, pediatric fractures, psychology.


Objectives: This study aimed to compare the course of anxiety change in children who used headphones during cast removal with controls in midterm follow-up.

Patients and methods: Sixty-six patients who underwent forearm fracture treatment with closed reduction and long arm casting between June 2021 and March 2023 were retrospectively reviewed. Patients were divided into two groups based on the use of headphones (n=27; 21 males, 6 females; mean age: 8.0±1.8 years; range, 6 to 12 years) or not (n=39; 27 males, 12 females; mean age: 8.9±1.8 years; range, 6 to 12 years) during cast removal with an oscillating saw. Primary outcome measures included preprocedure, postprocedure, and six-month anxiety assessments with the State-Trait Anxiety Inventory.

Results: There was an acute increase in the mean state anxiety scores after the procedure, which returned to below baseline at the six-month follow-up in the headphone (31.4±8.3, 33.3±8.7, and 25.1±4.1, respectively) and control groups (34.9±11.1, 37.4±9.5, and 27.3±5.3, respectively). The mean trait anxiety scores before the procedure, after the procedure, and at six months remained similar in the headphone (33.6±3.0, 34.6±3.2, and 32.4±2.8; p>0.05) and control groups (34.1±2.7, 33.7±3.0, and 33.7±3.0, p>0.05).

Conclusion: This study suggests that the acute anxiety during cast removal did not create anxiety sequelae in the sixth month regardless of headphone use.

Citation: Daşar U, Altun O, Ergişi Y, Arıkan O, Özdemir E. The midterm psychological effect of cast removal procedures in children. Jt Dis Relat Surg 2024;35(2):404-409. doi: 10.52312/ jdrs.2024.1689.

Ethics Committee Approval

The study protocol was approved by the Karabük University Non-Interventional Clinical Research Ethics Committee (date: 01.10.2021, no: 2021/661). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept, design, control/ supervision, data processing, literature review, writing of the article, critical review: U.D.; Idea/concept, data collection, literature review, writing of the article: O.A.; Idea/concept, design, literature review, writing of the article, critical review: Y.E.; Idea/concept, design, control/supervision, data processing and analysis, literature review, writing of the article, critical review: E.Ö.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.