Post-Traumatic Stress Disorder After Orthopaedic Trauma

Post-traumatic stress disorder (PTSD) is a mental illness that can occur after injury. It was first described among soldiers who had been in combat and experienced severe emotional or physical trauma. It is part of the body’s response to a horrible situation.

What is Post-Traumatic Stress?

If you are confronted with death or serious injury, your body responds in several ways. For example, you may feel a rush of emotions or energy. If the threat is sudden and overwhelming, you may feel fear, helplessness, or horror. Later, you may be unable to forget the sights, sounds, and feelings of the event. These memories may make it difficult for you to function in social or work settings.

People who develop PTSD respond in similar ways. These responses, or symptoms, are used by doctors to help diagnose the condition.

• You may have recurring memories, dreams, or feelings about the event. These are called intrusion symptoms. For example, you may have nightmares about the injury or get upset when talking about the event.
• You may go out of your way to avoid certain activities, places, or thoughts related to the event. You may say “no one understands how I feel” or push people away who try to help. These are called avoidance symptoms.
• You may become irritable and suddenly angry, or have difficulty concentrating or sleeping. An unexpected noise may make you jump, or you may feel the need to be constantly alert. These are called arousal symptoms.

A person must have all three types of symptoms to be diagnosed with PTSD.

PTSD in Orthopaedic Trauma

A study found that many patients who experienced an orthopaedic trauma, such as a gunshot wound or a fracture from a motor vehicle accident, developed symptoms of PTSD. In some cases, even though the injury healed properly, the patient continued to experience emotional problems.

Of the nearly 600 patients in the study, more than half had symptoms of PTSD. Among patients injured in vehicle crashes, 57 percent developed symptoms of PTSD. A person who was walking and struck by a car had an even higher risk of developing symptoms of PTSD. Two out of three people involved in vehicle-pedestrian collisions had symptoms of PTSD.

Post-traumatic stress disorder may not be evident right after the accident, but symptoms may develop over time. In this study, patients with more recent injuries were less likely to have symptoms of PTSD than those who had been injured some time ago.

Talk to Your Doctor

A serious injury can have a negative impact on your quality of life. For example, if your leg is broken in an automobile accident, you will experience pain and may need surgery to repair the leg. The orthopaedic surgeon may have to put a rod, pin, or plate in your leg to assist healing. For a while, you will probably have to use a walking aid such as crutches. It may be some time before you can resume sports and other activities.

In most cases, these physical effects gradually diminish. However, you and your doctor should be aware of, and address, other conditions that could affect your recovery. Your mental attitude is just as important to the final outcome as your physical response.

If you are having difficulty coping with the emotional effects of your injury, talk to your orthopaedic surgeon. In some cases, you may need a referral to a mental health professional. Other times, you may find it comforting just to know that there’s someone you can talk to about your feelings and response to the accident.