Abstract: Objective To investigate the incidence of post-traumatic stress disorder (PTSD) among patients with traumatic fractures and to analyze its associated risk factors. Methods A convenience sampling method was employed to recruit patients with traumatic fractures admitted to the orthopedic department of The Second People's Hospital of Taizhou between July 2021 and June 2024. A questionnaire-based survey was administered. The incidence of PTSD was analyzed using descriptive epidemiological methods, while univariate and multivariate analyses were utilized to identify its determinants. Results A total of 1 040 patients with traumatic fractures were included in the investigation. The incidence of PTSD was 11.15% (116 cases) at 1 month post-injury, decreasing to 6.63% (69 cases) at 3 months, and further to 2.12% (22 cases) at 6 months. Multivariate logistic regression analysis revealed that at 1 month post-injury, the significant risk factors for PTSD were female gender (OR=1.648), average monthly household income <2 000 RMB (OR=2.128), traffic accident as the cause of injury (OR=3.294), severe injury (OR=2.159), critical injury (OR=2.715), poor sleep quality (OR=1.532), severely deficient family support (OR=2.723), and an expected rehabilitation outcome of disability (OR=3.234) (all P<0.05). At 3 months post-injury, significant predictors included female gender (OR=2.602), severe injury (OR=2.316), critical injury (OR=4.552), poor sleep quality (OR=2.645), and an expected rehabilitation outcome of disability (OR=6.194) (all P<0.05). At 6 months post-injury, poor sleep quality (OR=4.267) and an expected rehabilitation outcome of disability (OR=4.745) remained significant risk factors (all P<0.01). Conclusions The incidence of PTSD in patients with traumatic fractures demonstrates a dynamic temporal pattern, with the highest prevalence observed in the initial post-traumatic period. The factors influencing PTSD onset vary at different time points post-injury. Notably, poor sleep quality and an anticipated outcome of disability are primary, persistent risk factors for the long-term development of PTSD.

Key words: Traumatic fracture, Post-traumatic stress disorder (PTSD), Epidemiology, Sleep disturbance, Rehabilitation prognosis