Beyond the Frame: Psychological Burden and Emotional Adaptation in Patient Undergoing External Fixation After Trauma

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Abstract
Background: External fixator devices are an additional treatment option for traumatic injuries to help immobilization of periarticular fractures and the tissue around it. Purpose: The purpose of this review is to synthesize the literature centered around external fixation devices and the impact that they can have on the mental and psychological well-being of the patient. Methods: The study aimed to examine the psychological impact of external fixation on patients through survey-based research design. This study assessed factors such as body image, anxiety and depressive symptoms during the post-operative period. Patients who had undergone external fixation for traumatic injuries were asked about their experience pre- and post-operative period to see the impact that external fixation devices can have on a patient’s psychological well-being. Results: Findings showed that psychological distress was greatest in patients undergoing external fixation devices post-traumatic injury. However, findings across studies vary widely regarding the psychological effects on patients, underscoring the need for further research to better understand these outcomes. Conclusion: This review examined the psychological impact of external fixation following a traumatic injury, emphasizing the emotional challenges faced by patients during recovery. Existing studies highlight early postoperative distress characterized by anxiety, loss of independence and altered body image. While some evidence suggests that patients gradually adapt to their circumstances overtime, findings across studies vary widely. Future research should continue to explore these factors with greater stratification by frame type and duration to better understand emotional recovery. Addressing these gaps will not strength the evidence base, but also enable orthopedic surgeons to deliver more holistic, patient-centered care that supports both physical healing and psychological well-being.

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