Noferesti Afshin, Movahedi Aliabadi Mehraneh, Bagheri Farshid
Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran.
Orthopedics Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran.
Int Orthop. 2025 Aug;49(8):1821-1827. doi: 10.1007/s00264-025-06567-4. Epub 2025 Jun 7.
Bone nonunion, a condition where fractures fail to heal within an expected timeframe, presents significant physical, psychological, and socioeconomic challenges. While various risk factors for nonunion have been extensively studied, the role of psychological factors, particularly anxiety, remains underexplored. This study aims to assess anxiety levels in patients with nonunion fractures and examine its associations with demographic factors such as age and gender.
This cross-sectional study included 180 adults with a history of repeated surgical interventions due to nonunion diaphyseal fractures of long bones. Participants' anxiety levels were measured using the State-Trait Anxiety Inventory (STAI), a validated psychological assessment tool. Data were retrospectively collected from hospital records, and statistical analyses were conducted to compare anxiety levels across different age groups and between genders.
A substantial proportion of participants with a history of nonunion fractures exhibited moderate to high anxiety levels, with 70.6% reporting moderate to high state anxiety and 85.6% experiencing moderate to high trait anxiety. While state anxiety was not significantly associated with age, trait anxiety levels were notably higher in older adults. No significant gender-based differences in anxiety levels were observed.
The findings underscore the psychological burden of nonunion fractures, particularly among older patients, highlighting the need for integrating mental health assessments into orthopaedic care. Given the potential impact of anxiety on fracture healing, future studies should employ prospective designs to evaluate the role of anxiety in long-term orthopaedic outcomes. Addressing psychological factors in nonunion patients may improve overall recovery and quality of life.
骨不连是指骨折在预期时间内未能愈合的一种情况，它带来了重大的身体、心理和社会经济挑战。虽然已经广泛研究了骨不连的各种风险因素，但心理因素，尤其是焦虑的作用仍未得到充分探索。本研究旨在评估骨不连骨折患者的焦虑水平，并研究其与年龄和性别等人口统计学因素的关联。
这项横断面研究纳入了180名因长骨干骨不连而有多次手术干预史的成年人。使用状态-特质焦虑量表（STAI）测量参与者的焦虑水平，这是一种经过验证的心理评估工具。数据从医院记录中回顾性收集，并进行统计分析以比较不同年龄组和不同性别之间的焦虑水平。
很大一部分有骨不连骨折史的参与者表现出中度至高度焦虑水平，70.6%的人报告有中度至高度状态焦虑，85.6%的人经历中度至高度特质焦虑。虽然状态焦虑与年龄没有显著关联，但老年人的特质焦虑水平明显更高。未观察到焦虑水平存在显著的性别差异。
研究结果强调了骨不连骨折的心理负担，尤其是在老年患者中，突出了将心理健康评估纳入骨科护理的必要性。鉴于焦虑对骨折愈合的潜在影响，未来的研究应采用前瞻性设计来评估焦虑在长期骨科结局中的作用。解决骨不连患者的心理因素可能会改善整体康复和生活质量。
