Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa
Background:. Fractures occur at disproportionately higher rates in low-income and middle-income countries (LMIC) and commonly occur following a traumatic event. The association between suffering from a fracture and the development of psychological symptoms is under-reported. The aim of this study wa...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2025-06-01
|
| Series: | JBJS Open Access |
| Online Access: | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.24.00124 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850139789988200448 |
|---|---|
| author | Gerald Tan, MBBS, MRCS, MSc Maritz Laubscher, MBChB, FC Orth (SA), MMed Sithombo Maqungo, MBChB, FC Ortho (SA), MMed Adam Truss, MBChB, BSc (Hons), MRCS Kirsty Berry, BSc, MBBCh, FC Orth(SA) Nando Ferreira, BSc, MBChB, FC (Orth), MMed, PhD Simon Matthew Graham, MBChB, MRCS, MSc (Res), FRCS (Orth), PhD |
| author_facet | Gerald Tan, MBBS, MRCS, MSc Maritz Laubscher, MBChB, FC Orth (SA), MMed Sithombo Maqungo, MBChB, FC Ortho (SA), MMed Adam Truss, MBChB, BSc (Hons), MRCS Kirsty Berry, BSc, MBBCh, FC Orth(SA) Nando Ferreira, BSc, MBChB, FC (Orth), MMed, PhD Simon Matthew Graham, MBChB, MRCS, MSc (Res), FRCS (Orth), PhD |
| author_sort | Gerald Tan, MBBS, MRCS, MSc |
| collection | DOAJ |
| description | Background:. Fractures occur at disproportionately higher rates in low-income and middle-income countries (LMIC) and commonly occur following a traumatic event. The association between suffering from a fracture and the development of psychological symptoms is under-reported. The aim of this study was to investigate the prevalence and risk factors of developing post-traumatic stress disorder (PTSD) among patients following lower limb trauma in South Africa.
Methods:. The study was undertaken from September 2017 to December 2018 and included a cohort of 260 patients with lower limb long bone fractures. Patients were screened using the Primary Care PTSD (PC-PTSD-5) screening tool, which is a gold standard measure to identify patients at risk of PTSD in the civilian population. Within this cohort, high-risk patients were assessed with the PTSD checklist (PCL-C), which is a standardized questionnaire scale to indicate if an individual may have PTSD.
Results:. There were 254 patients in the final cohort analysis with ages ranging from 18 to 71 years, and 75.6% (192/254) of the cohort were male patients. Femoral fractures were found in 51.6% (131/254) of patients while tibial fractures were found in 48.4% (123/254). The rate of PTSD within the study population was found to be 7.1% (18/254), and the risk of developing PTSD was 13.4% (34/254). We did not identify any risk factors, including open fractures, high-injury severity, and complication such as nonunion, for the development of PTSD.
Conclusions:. This study found the rate of PTSD to be lower compared with that in high-income countries, but still higher than the general population in South Africa. Our study indicates that screening for PTSD in patients with lower limb trauma in LMICs could be beneficial. Early identification of patients at risk of developing PTSD would enable appropriate resources, support, and treatment to be provided.
Level of Evidence:. Level II. See Instructions for Authors for a complete description of levels of evidence. |
| format | Article |
| id | doaj-art-1107dd4a01404086bcbbd1e4ae95766b |
| institution | OA Journals |
| issn | 2472-7245 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | JBJS Open Access |
| spelling | doaj-art-1107dd4a01404086bcbbd1e4ae95766b2025-08-20T02:30:06ZengWolters KluwerJBJS Open Access2472-72452025-06-0110210.2106/JBJS.OA.24.00124JBJSOA2400124Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South AfricaGerald Tan, MBBS, MRCS, MSc0Maritz Laubscher, MBChB, FC Orth (SA), MMed1Sithombo Maqungo, MBChB, FC Ortho (SA), MMed2Adam Truss, MBChB, BSc (Hons), MRCS3Kirsty Berry, BSc, MBBCh, FC Orth(SA)4Nando Ferreira, BSc, MBChB, FC (Orth), MMed, PhD5Simon Matthew Graham, MBChB, MRCS, MSc (Res), FRCS (Orth), PhD61 Mersey Orthopaedic Trainee Association, Liverpool, United Kingdom2 Orthopaedic Research Unit (ORU), Division of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa2 Orthopaedic Research Unit (ORU), Division of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa1 Mersey Orthopaedic Trainee Association, Liverpool, United Kingdom2 Orthopaedic Research Unit (ORU), Division of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa4 Division of Orthopaedic Surgery, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa3 Division of Global Surgery, University of Cape Town, South AfricaBackground:. Fractures occur at disproportionately higher rates in low-income and middle-income countries (LMIC) and commonly occur following a traumatic event. The association between suffering from a fracture and the development of psychological symptoms is under-reported. The aim of this study was to investigate the prevalence and risk factors of developing post-traumatic stress disorder (PTSD) among patients following lower limb trauma in South Africa. Methods:. The study was undertaken from September 2017 to December 2018 and included a cohort of 260 patients with lower limb long bone fractures. Patients were screened using the Primary Care PTSD (PC-PTSD-5) screening tool, which is a gold standard measure to identify patients at risk of PTSD in the civilian population. Within this cohort, high-risk patients were assessed with the PTSD checklist (PCL-C), which is a standardized questionnaire scale to indicate if an individual may have PTSD. Results:. There were 254 patients in the final cohort analysis with ages ranging from 18 to 71 years, and 75.6% (192/254) of the cohort were male patients. Femoral fractures were found in 51.6% (131/254) of patients while tibial fractures were found in 48.4% (123/254). The rate of PTSD within the study population was found to be 7.1% (18/254), and the risk of developing PTSD was 13.4% (34/254). We did not identify any risk factors, including open fractures, high-injury severity, and complication such as nonunion, for the development of PTSD. Conclusions:. This study found the rate of PTSD to be lower compared with that in high-income countries, but still higher than the general population in South Africa. Our study indicates that screening for PTSD in patients with lower limb trauma in LMICs could be beneficial. Early identification of patients at risk of developing PTSD would enable appropriate resources, support, and treatment to be provided. Level of Evidence:. Level II. See Instructions for Authors for a complete description of levels of evidence.http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.24.00124 |
| spellingShingle | Gerald Tan, MBBS, MRCS, MSc Maritz Laubscher, MBChB, FC Orth (SA), MMed Sithombo Maqungo, MBChB, FC Ortho (SA), MMed Adam Truss, MBChB, BSc (Hons), MRCS Kirsty Berry, BSc, MBBCh, FC Orth(SA) Nando Ferreira, BSc, MBChB, FC (Orth), MMed, PhD Simon Matthew Graham, MBChB, MRCS, MSc (Res), FRCS (Orth), PhD Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa JBJS Open Access |
| title | Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa |
| title_full | Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa |
| title_fullStr | Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa |
| title_full_unstemmed | Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa |
| title_short | Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa |
| title_sort | prevalence risk factors of post traumatic stress disorder in patients with lower limb fractures in south africa |
| url | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.24.00124 |
| work_keys_str_mv | AT geraldtanmbbsmrcsmsc prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica AT maritzlaubschermbchbfcorthsammed prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica AT sithombomaqungombchbfcorthosammed prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica AT adamtrussmbchbbschonsmrcs prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica AT kirstyberrybscmbbchfcorthsa prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica AT nandoferreirabscmbchbfcorthmmedphd prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica AT simonmatthewgrahammbchbmrcsmscresfrcsorthphd prevalenceriskfactorsofposttraumaticstressdisorderinpatientswithlowerlimbfracturesinsouthafrica |