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World J Psychiatry. Aug 19, 2026; 16(8): 120504
Published online Aug 19, 2026. doi: 10.5498/wjp.120504
Published online Aug 19, 2026. doi: 10.5498/wjp.120504
Influence of mental and psychological states on surgical outcomes following open reduction and internal fixation for trimalleolar ankle fractures
Xiao-Cong Liu, Shi-Hang Cao, Jian-Min Qu, Jing Huang, Yi Li, Jun Lu, Jun-Kui Xu, Department of Foot and Ankle Surgery, Honghui Hospital, Xi’an 710000, Shaanxi Province, China
Author contributions: Liu XC wrote the first draft of the manuscript, collected and analyzed the data, and was responsible for software operation and data visualization; Cao SH supervised the study and performed data validation; Qu JM contributed to data collection, formal analysis, investigation, software, and visualization; Huang J assisted with data collection; Li Y and Lu J participated in manuscript review and editing; Xu JK conceptualized the study, acquired funding, provided resources, supervised the research, validated the results, and drafted, reviewed, and edited the manuscript. All authors have read and approve the final manuscript.
AI contribution statement: No AI tools were used in the preparation of this manuscript.
Supported by 2024 Provincial Science and Technology Development Project of Shaanxi Province, No. 2024SF-YBXM-379.
Institutional review board statement: This study was approved by the Ethics Review Committee of Xi’an Honghui Hospital, No. 2025-KY-030-01.
Informed consent statement: Due to the retrospective design and the use of de-identified patient data, the Ethics Committee waived the requirement for written informed consent.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: Data will be provided if required.
Corresponding author: Jun-Kui Xu, Department of Foot and Ankle Surgery, Honghui Hospital, No. 555 Youyi East Road, Naanshaomen, Beilin District, Xi’an 710000, Shaanxi Province, China. 568720818@qq.com
Received: March 1, 2026
Revised: April 10, 2026
Accepted: June 4, 2026
Published online: August 19, 2026
Processing time: 139 Days and 18.3 Hours
Revised: April 10, 2026
Accepted: June 4, 2026
Published online: August 19, 2026
Processing time: 139 Days and 18.3 Hours
Core Tip
Core Tip: This retrospective study of 467 patients demonstrated that preoperative anxiety or depression independently predicts poorer postoperative outcomes following open reduction and internal fixation for trimalleolar ankle fractures. Outcomes include increased pain, reduced functional recovery, heightened central sensitization, and diminished quality of life. Patients presenting with both anxiety and depression exhibited the worst prognosis, underscoring the importance of preoperative psychological assessment.