Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 457-464
DOI: https://doi.org/10.52403/ijrr.20261041
Delays in Fracture Care for Pediatric Patients in Saiful Anwar General Hospital: A Case Report of Challenges and Clinical Consequences
Panji Sananta1, Respati S. Dradjat1, Dwilan Achmad Fauzan1
1Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Brawijaya – Dr. Saiful Anwar General Hospital, Malang, Indonesia
Corresponding Author: Panji Sananta
ABSTRACT
ABSTRACT
Introduction: Delays in medical care for pediatric fractures in Indonesia may result from financial constraints and administrative barriers related to BPJS/Kartu Indonesia Sehat (KIS) health coverage. Such delays can allow initially manageable injuries to progress into complex conditions. This case report describes the clinical and systemic consequences of delayed treatment in a five-year-old child with a neglected elbow fracture and highlights challenges in healthcare accessibility under the national health insurance system.
Case Presentation: A five-year-old boy sustained a right elbow fracture after a fall. Initial symptoms consisted of intermittent pain and mild swelling, but medical treatment was not immediately sought. One month later, an open wound developed with visible bone exposure. Because the patient was not enrolled in BPJS/KIS and the family had financial limitations, definitive treatment was further delayed while obtaining KIS coverage. Approximately four months after the injury, the patient was admitted with osteomyelitis and severe elbow stiffness. Radiographic examination demonstrated a distal humeral fracture. Surgical management included urgent debridement, sequestrectomy, and primary wound closure, followed by additional surgical intervention for extensive tissue damage and joint dysfunction.
Clinical Discussion: This case demonstrates how administrative and socioeconomic barriers to healthcare access may contribute to substantial deterioration of treatable pediatric injuries. Delayed management transformed a fracture into a complex orthopedic and infectious condition requiring multiple surgical procedures.
Conclusion: Timely access to pediatric orthopedic care is essential to prevent avoidable complications. Streamlining insurance activation and improving healthcare accessibility for socioeconomically vulnerable patients may reduce treatment delays and improve clinical outcomes.
Keywords: fracture; healthcare access; pediatric; universal health coverage.
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