Although most commonly associated with military combat, post-traumatic stress disorder (PTSD) can occur in civilians, too and with consequences that are just as serious, according to a new review article in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). PTSD is a type of anxiety disorder that occurs after a person experiences a traumatic event involving physical injury, and occurs in 20 to 51 percent of patients with an orthopaedic 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 in Providence, R.I.
Many types of accidents can cause PTSD, including car or motorcycle accidents, gunshot wounds, vehicle-pedestrian accidents and falls from height, among many others.
"Generally, higher-energy mechanisms are most commonly associated with PTSD, but no specific type of fracture or injury has been identified," Dr. Aaron said. "Basically, any type of muscuolskeletal injury that results from significant trauma may be associated with PTSD."
PTSD can have a significant impact on a patient's ability to perform simple, daily chores, and can slow the rehabilitation process, even affecting how the patient experiences pain and perceives his or her recovery.
"The development of PTSD adversely affects the ability of the patient to recover and may specifically compromise physical rehabilitation and patient satisfaction following orthopaedic treatment," Dr. Aaron said. "Without effective treatment, PTSD can hinder activities of daily living, such as bathing, eating, paying bills, shopping, laundry and other household chores. Patients with PTSD also may be delayed in returning to work."
A diagnosis of PTSD relies on the presence of s
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American Academy of Orthopaedic Surgeons