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Post-traumatic stress disorder common following significant orthopedic trauma
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Up to 51% of patients with musculoskeletal injuries develop post-traumatic stress disorder, according to a review article in the Journal of the American Academy of Orthopaedic Surgeons.
The review noted that while the development of post-traumatic stress disorder (PTSD) is frequently associated with military combat or injuries sustained therein, many types of accidents are capable of causing PTSD in civilians — including car or motorcycle accidents, gunshot wounds, vehicle-pedestrian accidents and falls.
“PTSD occurs in 20% to 51% of patients with musculoskeletal injury,” the authors wrote. “Orthopedic outcomes, including return to work, activities of daily living, patient perception of physical recovery, and objective physical parameters, suffer considerably in patients with PTSD.”
According to an American Academy of Orthopaedic Surgeons (AAOS) press release, a diagnosis of PTSD relies on the presence of specific behaviors or symptoms such as re-experiencing the traumatic event, including nightmares, flashbacks and intrusive memories; avoiding situations reminiscent of the original trauma, reluctance to talk or think about the original trauma, or feeling emotionally “numb” about the event; and anger, irritability, difficulty concentrating, insomnia or an increased startle response. The symptomsmust have occurred for at least a month and be severe enough to cause a noticeable change in typical behavior.
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“PTSD occurs with a significant frequency in civilian patients who have sustained an orthopedic trauma, and it can hinder their emotional, physical and functional recovery following orthopedic treatment,” review author Daniel L. Aaron, MD, stated in the release. “Generally, higher-energy mechanisms are most commonly associated with PTSD, but no specific type of fracture or injury has been identified. Basically, any type of musculoskeletal injury that results from significant trauma may be associated with PTSD.”
PTSD can reportedly occur in any person at any age, but Aaron noted in the release several risk factors that make its development more likely. These include use of drugs or alcohol, lower levels of education, socioeconomic status, young age and female gender. The authors concluded by noting further research is needed regarding a potential correlation between successful management of the psychiatric manifestations of PTSD and improved physical outcomes.
Reference:
- Aaron DL, Fadale PD, Harrington CJ, Born CT. Posttraumatic stress disorders in civilian orthopaedics. J Am Acad Orthop Surg. 2011:19(5): 245-250.
- www.aaos.org
- Disclosure: Aaron has no relevant financial disclosures.
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