足と足首の臨床研究

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Risks and Outcomes of Extremity Fractures in Patients with Known Mental Health Disorders: An Ortho-Psychiatric Perspective and a Systematic Review of the Literature

Uzma Saeed, Haroon Majeed

Objective: We aim to review the risks and outcomes of fractures in patients with pre-existing mental health disorders. Methods: Articles published in the English language from Jan 2000 to March 2020 were searched through PubMed, Ovid, Embase, ScienceDirect and ISI Web of Knowledge. Medical Subject Headings (MeSH) terms were used along with text words. Applying the inclusion and exclusion criteria, of the 390 searched articles, 13 were included for final analysis in line with recommendations from PRISMA guidelines. Main Results: Total participants from all these studies were 1,11,61,087 with a combined mean age of 51.4 years. Two-thirds of the participants were females. The combined mean of fractures and falls was 61.8% among all participants in included studies. The combined mean incidence of mental health disorders was 74.3% among all participants with fractures. Use of psychotropic medications was found to be associated with impairment of cognition, psychomotor function and bone mineral density leading to a substantial increase in fracture risk. Conclusion: Patients with fractures and underlying mental health disorders were reported to have a prolonged hospital stay, poor functional outcomes and increased risk of chronic pain syndrome. Strategies should be in place for early identification of psychiatric disorders following a fracture to mobilize psychosocial support and facilitate discharge.