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Chronic psychological and functional sequelae after emergent hand surgery
Todd Richards1, Donn W Garvert, Elizabeth McDade
1Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
The Journal of Hand Surgery
|August 25, 2011
Summary
Severe hand trauma can lead to lasting psychological distress, including depression and PTSD. Hand disability and pain are strongly linked to these persistent mental health issues long after the initial injury.
Area of Science:
- Orthopedic Surgery
- Psychiatry
- Trauma Care
Background:
- Upper extremity trauma is known to cause acute psychological distress.
- The long-term psychological impact of severe hand trauma requires further investigation.
Purpose of the Study:
- To assess psychological outcomes (depression, PTSD, psychosocial variables) and hand function (QuickDASH) after severe hand trauma.
- To test the hypothesis that psychological sequelae of hand trauma persist long after physical recovery.
Main Methods:
- Cross-sectional survey of 34 patients undergoing emergency hand surgery.
- Utilized validated instruments: QuickDASH, CES-D, SPTSS, MOS-SSS, SCS, PSS.
- Data collected an average of 16 months post-surgery.
Main Results:
- Overall QuickDASH score averaged 27.
- Mean PTSD score was 13, exceeding the clinical threshold.
- 29% reported high levels of both depression and PTSD.
- High pain scores correlated significantly with depression and PTSD symptoms.
Conclusions:
- Patients with severe hand trauma experience significant psychological distress.
- Hand disability is closely associated with pain, depression, and PTSD.
- Psychological consequences of hand trauma can be long-lasting.
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