Disability and depression after orthopaedic trauma

Abstract Introduction Musculoskeletal injury is a common cause of impairment (pathophysiology), but the correlation of impairment with pain intensity and magnitude of disability is limited. Psychosocial factors explain a large proportion of the variance in disability for various orthopaedic pathologies. The aim of this study is to prospectively assess the relationship between psychological factors and magnitude of disability in a sample of orthopaedic trauma patients in The Netherlands. Material and methods One hundred and one adult patients between 1 and 2 months after one or more fractures, tendon or ligament injuries were enrolled. Four eligible patients refused to participate. Thirty-five women and 30 men with an average age of 50 years (range, 22–92 years) completed the follow-up evaluation between 5 and 8 months after their injury and their data was analyzed. The patients completed a measure of disability (the Short Musculoskeletal Function Assessment-Netherlands, SMFA-NL), the Dutch Centre for Epidemiologic Study of Depression-scale (CES-D), the Dutch Impact of Event Scale (SVL), and the Dutch Pain Catastrophizing Scale (PCS) at the time of enrollment and again 5–8 months after injury. Results There were moderate correlations between symptoms of depression (CES-D, r  = 0.48, p r  = 0.35, p  = 0.004) at enrollment and magnitude of disability 5–8 months after trauma. Catastrophic thinking (PCS) at enrollment and magnitude of disability 5–8 months after trauma showed a small correlation (PCS, r  = 0.26, p  = 0.034). The Pain Catastrophizing Scale (Beta = 0.29; p  = 0.049), surgery (Beta = 0.26; p  = 0.034), additional surgery (Beta = 0.26; p  = 0.019) and other pain conditions (Beta = 0.31; p  = 0.009) were the significant predictors in the final model (adjusted R -squared = 0.35; p Discussion and conclusions In The Netherlands, symptoms of depression measured 1–2 months after musculoskeletal trauma correlate with disability 5–8 months after this trauma. The psychological aspects of recovery from musculoskeletal injury merit greater attention. Level of evidence Level II, Prognostic study.