Session VIII - General Interest

Sat., 10/12/13 Topics of General Interest, PAPER #89, 12:53 pm OTA 2013

Sleep Disturbance Following Fracture Is Related to Emotional Well-Being Rather Than Functional Result

Brandon S. Shulman, BA1; Frank Liporace, MD1; Roy I. Davidovitch, MD1;
Raj J. Karia, MPH1; Kenneth A. Egol, MD1,2;
1NYU Hospital for Joint Diseases, New York, New York, USA;
2Jamaica Medical Center, Jamaica, New York, USA

Background/Purpose: Sleep disturbance is an extremely common complaint following orthopaedic trauma. However, the incidence, severity, and duration of sleep difficulty following common orthopaedic trauma surgeries are unknown. The aim of our study was to investigate the incidence and longitudinal improvement of sleep disturbance following four common orthopaedic traumatic conditions.

Methods: We reviewed prospectively collected functional outcomes data for 1095 orthopaedic trauma patients following four common orthopaedic trauma conditions. The functional status of patients with proximal humerus fractures (n = 111), distal radius fractures (n = 440), tibial plateau fractures (n = 109), and ankle fractures (n = 435) were followed with standard functional outcome measures. Surveys were conducted at 3, 6, and 12 months postoperatively. Patient-reported sleep disturbance, acquired from validated functional outcome surveys, was compared to overall functional outcomes scores and demographic information. Subgroup analysis was conducted for age, gender, body mass index, mechanism of injury (high versus low energy), and presence of additional fractures.

Results:

At 12-month follow-up the Short Form-36 Mental Health category for patients with distal radius fractures (P = 0.001) and the Short Musculoskeletal Function Assessment (SMFA) Emotional category for patients with tibial plateau fractures (P = 0.024) and ankle fractures (P ≤0.001) were independent predictors of poor sleep while the respective functional status categories were not.

Conclusion: At 12-month follow-up, poor sleep was independently associated with poor emotional status, but not associated with poor functional status. The mental health status of patients with sleep difficulty in the latter stages of fracture healing should be carefully assessed in order to provide the highest level of care. The results of this study should allow orthopaedic trauma surgeons to counsel patients regarding expectations of difficulty sleeping following acute fractures.

Alphabetical Disclosure Listing

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.