PTSD Common Among Orthopedic Trauma Patients

Although we normally associate post-traumatic stress disorder (PTSD) with soldiers returning from military combat, it also may occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, violent personal assault such as rape, or other life-threatening events. It is even quite common in civilians who have experienced a significant physical injury. And the consequences can be just as serious.

According to an article published by the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), this type of anxiety disorder occurs in 20-51% of patients with an orthopedic injury.

“PTSD occurs with a significant frequency in civilian patients who have sustained an orthopaedic trauma, and it can hinder their emotional, physical, and functional recovery following orthopaedic treatment,” said Daniel Aaron, MD, a clinical instructor in the department of orthopaedics at Brown University.

There are many very common accidents that can cause PTSD, including car or motorcycle accidents, gunshot wounds, vehicle-pedestrian accidents, falls from great heights, among others. “Basically, any type of muscuolskeletal injury that results from significant trauma may be associated with PTSD,” Dr. Aaron said.

Victims of these accidents that consequently suffer from PTSD experience a significant negative impact on their rehabilitation and recovery process. They also struggle with the ability to perform simple daily activities such as eating, bathing, paying bills, shopping, and other household chores.

Like with all disorders, early detection is key to recovery. Diagnosing PTSD relies on the presence of specific behaviors or symptoms that include:

-- re-experiencing the traumatic event, including nightmares, flashbacks, and intrusive memories

-- avoiding situations reminiscent of the original trauma, reluctance to talk about the original trauma, or generally feeling emotionally numb about the event

-- anger, irritability, difficulty concentrating, insomnia, and/or an increased startle response

These symptoms must have occurred for at least one month, and they must be severe enough to cause a noticeable change in behavior or lifestyle.

Although PTSD can occur in any person, Dr. Aaron points to several risk factors that make PTSD more likely to occur. These risks include use of drugs or alcohol, less education, socioeconomic status, young age, or female gender.

Orthopaedic surgeons can improve patient outcomes by recognizing which patients are at a greater risk of developing PTSD and initiating prevention strategies.

“Although no single prevention protocol has been described, therapy with a psychiatrist or psychologist may help, as well as the use of certain medications, including anti-depressants and anti-anxiety medications,” Dr. Aaron said.

PTSD is a serious anxiety disorder with potentially damaging and long-lasting effects. It is not something to be ignored or trivialized. But by getting help from an experienced psychiatrist or psychologist, along with the right medications, it can be overcome.

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