Effectiveness of virtual reality in reducing pain and fear in children with closed reduction applied forearm fractures.

BACKGROUND: Painful procedures such as closed reduction of forearm fractures are a major source of procedural pain and fear in children. Virtual reality (VR) has gained attention as a non-pharmacological distraction adjunct to standard care. This study determined the effectiveness of VR in reducing pain and fear in children undergoing closed reduction of forearm fractures. METHOD: A quasi-experimental pre-post test unmatched group design was used in the orthopedics and emergency departments of a training and research hospital between June 2023 and November 2025. Fifty-one children aged 6-12 years scheduled for closed reduction were enrolled (control, n = 26; intervention, n = 25). The intervention group watched age-appropriate 360-degree videos through a VR headset throughout the procedure. Data were collected with the Child Information Form, Child Follow-up Form, Child Fear Scale, and Wong-Baker FACES Pain Rating Scale before, during, and after the procedure. RESULTS: Mean age was 7.69 ± 1.69 years in the control group and 7.12 ± 1.48 in the intervention group; 53.8% and 60% were male, respectively. VR significantly reduced heart rate, pain, and fear and increased oxygen saturation (p < 0.001), whereas adverse physiological and psychological changes occurred in the control group during the procedure. CONCLUSIONS: VR is an effective and feasible non-pharmacological intervention for reducing procedural pain and fear during closed reduction of forearm fractures. IMPLICATIONS TO PRACTICE: VR is low-cost, safe, and easily implemented in routine closed reduction. It may reduce procedural distress, support physiological stability, and improve the care experience of school-age children.