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Nonunion
5%
76/1604
Malunion
2%
33/1604
Infection
1%
15/1604
Post-traumatic stress disorder (PTSD)
81%
1299/1604
Fat embolism
11%
173/1604
Select Answer to see Preferred Response
Females are four times more likely to develop post-traumatic stress disorder (PTSD) following a traumatic event resulting in orthopedic injuries. Mental and physical rehabilitation following orthopedic injuries has come to the forefront in recent years as it optimizes patient recovery. Numerous studies have outlined the negative influence of psychological disorders on outcomes after orthopedic surgery. Post-traumatic stress disorder, specifically, is characterized by flashbacks, nightmares or severe anxiety following a traumatic event. Overall, patients sustaining lower extremity fractures, including pelvic injuries, are twice as likely to develop PTSD, when compared to those of the upper extremity. Furthermore, females were found to be four times as likely to develop PTSD following orthopedic trauma. Muscatelli et al. review the prevalence of depression and PTSD following acute orthopedic trauma. They report that one-third of patients suffer from depression and 25% suffer from PTSD after acute orthopedic injuries. In subgroup analysis, female sex and event severity were both associated with an increased risk of developing depression and PTSD. They conclude that treatment strategies, including screening, should address both mental and physical rehabilitation following these injuries in order to optimize patient outcomes. Lee et al. review PTSD and its association with extremity fractures. They report that lower extremity fractures, multiple fractures, and a higher pain visual analog score were significantly related to the occurrence of PTSD. They conclude that physicians must address both physical and psychological needs to optimize patient recovery. Figures A and B are the AP and lateral radiographs, respectively, demonstrating a closed diaphyseal femoral shaft fracture. Incorrect Answers: Answer 1 and 2: The female sex has not been linked to an increased rate of malunion or nonunion. Answer 3: Infection following fixation of diaphyseal femur fractures has not been shown to be related to sex. Answer 5: Gender has no association with an increased prevalence of fat embolisms following femoral nails.
3.8
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