Assessment of Signs of Anxiety and Depression Post Ilizarov Fixation: A Prospective Observational Study

Introduction: The management of various lower limb bones and in some cases upper limb bones, using the Ilizarov ring fixator is a well-known method of fixation. However, the psychological effects it has post-fixation on the mental health of patients are often overlooked. The authors conducted a study to assess signs of anxiety and depression following fixation to illuminate this aspect. Aim: To thoroughly investigate and highlight the signs of anxiety and depression that may emerge in patients after undergoing Ilizarov fixation surgery. Materials and Methods: This is a prospective observational study conducted from June 2023 to June 2024 in the Orthopaedics Department of Dr. D. Y. Patil Hostel, Pimpri, Chinchwad, Pune, Maharashtra, India. A total of 20 patients were selected for the study, which included cases of unilateral compound tibia fractures, tibia non union, femur non union and compound femur fractures in patients who underwent Ilizarov fixation. To evaluate signs of anxiety and depression, the used the Hospital Anxiety and Depression Scale (HADS). For each patient, the scale was administered during the hospital stay and three months following discharge. A paired t-test was used to compare the statistical values of the HADS system at the time of hospital stay and at the three-month follow-up following discharge. A p-value <= 0.05 was considered significant. Results: The results indicated a notable difference in anxiety and depression, with significantly lower p-values. Specifically, the p-value for anxiety was 0.008 when comparing hospital stay to three months post-discharge, whereas the p-value for depression was 0.005, which signifies active signs of anxiety and depression following the procedure. Conclusion: While the Ilizarov procedure has numerous benefits in improving the status of the affected limb over time, it also has debilitating effects on the mental status of patients, as demonstrated in the present study. Recommendations include counselling patients during follow-up to encourage psychological support and regular mental check-ups whenever possible.