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Surgeons reported that psychiatric problems, such as anxiety, depression, and posttraumatic stress disorder (PTSD), can affect clinical outcomes and should be evaluated after trauma.22) Pre-injury Mental Disorders Falls account for the largest proportion of injuries in people with mental disorders, and in the United Kingdom, 3% to 15% of suicide attempts are caused by falls every year.23-25) Most of these patients had social or economic problems.26) In order to treat them, surgical treatment should proceed, but a multidisciplinary approach with psychiatric treatment is required after surgery.27) In a study of 332 polytrauma patients with an injury severity score of 15 or higher, 39.2% of the patients had a mental illness before injury.28) Also, among mental disorders, depression (22.3%) and drug addiction (16.9%) were the most common, and depression increased the risk of postoperative complications, such as acute renal failure, multiple organ failure, sepsis, deep venous problems such as thrombosis, infection, and pulmonary complications by about three times. Falls from a height are a major cause of significant trauma with high morbidity and mortality rates. Faggiani et al.27) investigated 137 severe trauma patients injured by falls from heights. They compared two groups by classifying trauma patients as 65 suicide attempt survivors and 72 159 Yoo et al. Mental Disorder in Orthopedic Patients Clinics in Orthopedic Surgery • Vol. 14, No. 2, 2022 • www.ecios.org accidental fall victims. The cause of trauma in the suicide attempt survivors was mostly depression. The suicide attempt survivors included more women and falls from greater heights than accidental fall victims. That is, trauma caused by a mental disorder may more likely accompany more severe injury. Post-injury Mental Disorders Shelley et al.29) conducted a survey of 160 trauma patients who visited a level I trauma center in the southwestern United States between 2012 and 2014. They reported that PTSD and depression occurred in approximately 21%–29% of patients at 1 year after orthopedic trauma, and these mental disorders were typical for patients who received ventilators, were in an intensive care unit, or had long hospital stays. Wu et al.30) reported that, in an analysis of psychotic stress in 323 patients with orthopedics injury, the most common symptoms were sleep disorder, gastrointestinal symptoms, and anxiety; these were associated with being female and longer hospitalization. A retrospective study in China reported that among orthopedic patients admitted to the trauma ward, sleep disorder with the Pittsburgh sleep quality index > 5 was observed in 51.4%, and severe sleep disorder with a Pittsburgh sleep quality index > 10 was observed in 15.4% of the patients.31) Moreover, they reported that sleep quality was not related to VAS. McMinn et al.32) investigated psychological morbidity and functional impairment in pelvic trauma patients. Although pain and alcohol use decreased 1 year after trauma, PTSD and depression did not improve, and the quality of life continued to decline. Suicide in Osteoporotic Fractures Risk factors for suicide range from having low income and alcohol abuse to suffering from cancer, mental disorders, and chronic pain.33-36) Among the identified risk factors, aging is a major factor influencing the suicide rate, with the rate increasing among the elderly.37,38) Osteoporotic hip fractures and vertebral compression fractures in the elderly severely restrict patients’ physical mobility because of poor functional recovery and chronic pain, increase psychological stress, and cause strain in family dynamics.39,40) Also, a retrospective cohort study using data from Taiwan’s National Health Insurance Research Database reported that hip fractures in elderly patients increased the risks of depression and dementia.41) Jang et al.42,43) investigated the incidence rate and hazard ratio (HR) using Cox’s proportional hazard model of suicide death for elderly hip fractures and vertebral compression fractures in a Korean nationwide cohort study. During the first 180 days. A Review Paper E434 The American Journal of Orthopedics ® November/December 2016 www.amjorthopedics.com An Overview of the History of Orthopedic Surgery Ishaan Swarup, MD, and Joseph F. O’Donnell, MD T he modern term orthopedics stems from the older word orthopedia, which was the title of a book published in 1741 by Nicholas Andry, a professor of medicine at the University of Paris.1 The term orthopedia is a composite of 2 Greek words: orthos, meaning “straight and free from deformity,” and paidios, meaning “child.” Together, orthopedics literally means straight child, suggesting the importance of pediatric injuries and deformities in the development of this field. Interestingly, Andry’s book also depicted a crooked young tree attached to a straight and strong staff, which has become the universal symbol of orthopedic surgery and underscores the focus on correcting deformities in the young (Figure).1 While the history of the term is relatively recent, the practice of orthopedics is an ancient art. Orthopedic surgery is a rapidly advancing medical field with several recent advances noted within orthopedic subspecialties,2-4 basic science,5 and clinical research.6 It is important to recognize the role of history with
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