title: Posttraumatic stress disorder associated with orthopaedic trauma: a study in patients with extremity fractures.
abstract: OBJECTIVE
  The aims of this prospective study were to determine the prevalence of posttraumatic stress disorder (PTSD) in a population of young male military conscripts who experienced an extremity long-bone fracture, and to evaluate whether injury-related variables are associated with the development of PTSD.
  
  
  METHODS
  Prospective, nonrandomized comparative study.
  
  
  METHODS
  Level 1 trauma center.
  
  
  METHODS
  A total of 148 men (age older than 18 years) who had 1 or more acute long-bone extremity fractures within 12 months and were seen at the Seoul Regional Military Manpower Center for examination of military conscripts from March 2013 to March 2014, were enrolled. The Korean version of the posttraumatic disorder scale was used to identify aspects of PTSD. The injury-related variables assessed included injury mechanism, fracture location and multiplicity, fracture severity, and the occurrence of joint ankylosis and secondary osteoarthritis.
  
  
  RESULTS
  Of the 148 participants, 40 (27.0%) met the criteria for the diagnosis of PTSD. Multivariate logistic linear analysis confirmed that lower extremity fracture, multiple fractures, and a higher pain visual analog scale score were significantly (P = 0.042, P = 0.043 and P < 0.001, respectively) related to the occurrence of PTSD.
  
  
  CONCLUSIONS
  Lower extremity fracture, multiple extremity fractures, and higher pain visual analog scale scores were significantly related to the occurrence of PTSD. To achieve an optimal recovery after orthopaedic injury, clinicians must address both physical and psychologic needs of their patients.
  
  
  METHODS
  Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea; and †Department of Physical Education, Kyonggi University, Suwon-si, Gyeonggi-do, Korea.
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: Lee
authors.forename: Choong Hyeok
authors.initials: CH
authors.lastname: Choi
authors.forename: Sang-Young
authors.initials: SY
authors.lastname: Yoon
authors.forename: Jin Kyu
authors.initials: JK
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000453:epidemiology* / Q000523:psychology; D015984:Causality; D015897:Comorbidity; D050723:Fractures, Bone / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D015994:Incidence; D007869:Leg Injuries / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult