Psychological outlook and recovery after orthopaedic trauma: Evidence and implications for Central India and other low-resource settings.

Abstract

Orthopaedic trauma is frequently accompanied by psychological distress, including depression, anxiety, and post-traumatic stress, particularly in low- and middle-income countries. Beyond injury severity and surgical factors, psychological outlook-encompassing negative cognitions (e.g., catastrophising) and positive constructs (e.g., optimism, resilience, social support)-may substantially influence pain, disability, and functional recovery [3,4,6,17,18]. To narratively review evidence on the impact of psychological outlook on clinical, functional, and psychosocial outcomes after orthopaedic trauma, with emphasis on India, Central India, and comparable low-resource settings [4,10,17]. A structured narrative review of English-language studies (January 2000-October 2025) was conducted using PubMed, Scopus, and Google Scholar. Observational and interventional studies examining associations between psychological factors and pain, disability, function, quality of life, or rehabilitation outcomes in adult orthopaedic trauma populations were included [4,6,15]. Across diverse settings, approximately one-quarter to one-half of orthopaedic trauma patients experience clinically significant psychological distress, which consistently predicts higher pain, greater disability, and poorer quality of life independent of injury characteristics [2-4,14,15,17,18]. Catastrophising and fear-avoidance beliefs are associated with delayed functional recovery, whereas optimism, self-efficacy, and social support correlate with better rehabilitation adherence and outcomes [5,7,14-16,18]. Indian context literature highlights high distress burden and important modifiers including stigma, family dynamics, and socioeconomic stress [9,10]. Psychological outlook is a modifiable determinant of recovery after orthopaedic trauma. Integrating brief psychological screening and low-cost, culturally sensitive support strategies into routine trauma care represents a pragmatic opportunity to improve outcomes in Central India and similar low-resource settings [6,10,17-19].