Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Engineering Research Center for Orthopedic Material Innovation and Tissue Regeneration, Shanghai, China.
Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
J Shoulder Elbow Surg. 2022 Mar;31(3):469-480. doi: 10.1016/j.jse.2021.11.014. Epub 2021 Dec 27.
Joint stiffness is a common complication after articular-related trauma in the elbow, resulting in significant limb disability, psychological stress, and a negative impact on daily life. No previous study has reported the impact of post-traumatic elbow stiffness (PTES) on psychological health. This study aims to (1) investigate the depression and anxiety levels and (2) identify factors independently associated with depression and anxiety symptoms in patients with PTES.
A total of 108 patients with PTES presenting to 4 collaborative municipal hospitals were consecutively enrolled from September to December 2020. Sociodemographic and clinical characteristics were collected through questionnaires and medical records. The Depression Anxiety Stress Scale-21 was used to assess depression and anxiety status. Ordinal logistic regression analysis was performed to identify factors independently associated with depression and anxiety symptoms.
The detection rates of mild-to-moderate depression and anxiety are 40.7% and 27.8%, and severe-to-extremely severe levels are 23.1% and 25.9%, respectively. Regression results show that factors independently associated with depression include elbow flexion (odds ratio [OR] = 1.021, 95% confidence interval [CI]: 1.001-1.041, P = .035), elbow pain on movement (OR = 1.236, 95% CI: 1.029-1.484, P = .023), family relationship (OR = 10.059, 95% CI: 2.170-46.633, P = .003), and self-care ability (OR = 3.858, 95% CI: 1.244-11.961, P = .019). Factors independently associated with anxiety are elbow flexion (OR = 1.031, 95% CI: 1.009-1.052, P = .005), elbow pain on movement (OR = 1.212, 95% CI: 1.003-1.465, P = .047), and clinically significant heterotopic ossification around elbow (OR = 2.344, 95% CI: 1.048-5.243, P = .038).
Patients with PTES exhibit significant depression and anxiety symptoms. Several sociodemographic and clinical characteristics are independently associated with depression and anxiety levels. Identifying and addressing these factors may be of particular benefit during PTES management. Future research might address whether depression and anxiety affect the outcome after stiff elbow surgery.
肘部关节相关创伤后出现关节僵硬是一种常见并发症，导致肢体严重残疾、心理压力，并对日常生活产生负面影响。既往研究尚未报道创伤后肘僵硬（PTES）对心理健康的影响。本研究旨在：（1）调查抑郁和焦虑水平；（2）确定与 PTES 患者抑郁和焦虑症状相关的独立因素。
2020 年 9 月至 12 月，连续纳入来自 4 家协作市级医院的 108 例 PTES 患者。通过问卷和病历收集社会人口学和临床特征。采用抑郁焦虑压力量表 21 版（DASS-21）评估抑郁和焦虑状况。采用有序逻辑回归分析确定与抑郁和焦虑症状相关的独立因素。
轻度至中度抑郁和焦虑检出率分别为 40.7%和 27.8%，重度至极重度水平分别为 23.1%和 25.9%。回归结果显示，与抑郁相关的独立因素包括肘屈曲（比值比 [OR] = 1.021，95%置信区间 [CI]：1.001-1.041，P =.035）、活动时肘痛（OR = 1.236，95% CI：1.029-1.484，P =.023）、家庭关系（OR = 10.059，95% CI：2.170-46.633，P =.003）和自我护理能力（OR = 3.858，95% CI：1.244-11.961，P =.019）。与焦虑相关的独立因素包括肘屈曲（OR = 1.031，95% CI：1.009-1.052，P =.005）、活动时肘痛（OR = 1.212，95% CI：1.003-1.465，P =.047）和肘部周围明显异位骨化（OR = 2.344，95% CI：1.048-5.243，P =.038）。
PTES 患者存在明显的抑郁和焦虑症状。一些社会人口学和临床特征与抑郁和焦虑水平独立相关。在 PTES 管理期间，识别和处理这些因素可能特别有益。未来的研究可能会探讨抑郁和焦虑是否会影响僵硬肘手术后的结果。
