Psychosocial Impact of Prolonged Skeletal Traction of Lower Extremity Fractures in a Philippine Specialty Tertiary Government Hospital

Abstract

Introduction. Skeletal traction for lower extremity injuries remains a preliminary treatment in managing lower extremity fractures in a Philippine tertiary orthopedic hospital. Studies have shown an increased prevalence of the development of depression and anxiety among those confined on skeletal traction before their definitive surgery. Objective. This study associated variables present in the patient population to the development of depressive and/or anxiety symptoms while on skeletal traction before surgery for lower extremity fractures. Methodology. Depression and anxiety symptoms were determined using the Hospital Anxiety and Depression Scale in Filipino Version (HADS-P), which is the validated Filipino language version. Clinical and social variables were gathered from patient interviews before the administration of the scoring tool. The HADS-P questionnaire was administered before skeletal traction and a day before definitive surgery. Results. The study included fifty-four adult patients without prior psychiatric diagnoses and medications indicated for lower extremity skeletal traction before surgery. The results showed an increase in depressive and anxiety symptoms among the population. However, no significant difference was seen relative to the identified demographics. There was a minimum traction duration of 30 days and a maximum of 76 days. Conclusion. All patients exhibited increased depressive symptoms, however, the longer the duration of traction, the more depressed they got however with less or retained anxiety symptoms. The incidence of these symptoms did not have a significant relationship to the number of days they were in traction nor with the identified patient demographics.

Keywords

• skeletal traction
• depression
• anxiety
• orthopedic surgery
• days on skeletal traction