Influence of mental and psychological states on surgical outcomes following open reduction and internal fixation for trimalleolar ankle fractures

Figure 1 Preoperative imaging data of patients with trimalleolar fractures. A: Anteroposterior X-ray demonstrating cortical discontinuity of the fibula and medial malleolus, with lateral displacement of the talus; B: Lateral X-ray demonstrating cortical discontinuity of the posterior malleolus, with associated talar displacement.

Figure 2 Postoperative imaging data of patients with trimalleolar fractures. A and B: Anteroposterior and lateral X-rays demonstrating restoration of normal ankle joint alignment, with stable and well-positioned internal fixation and evidence of fracture healing.

Figure 3 Comparison of evaluation indicators between the two patient groups. A: Preoperative; B: Postoperative. VAS: Visual Analogue Scale; HADS-A: Hospital Anxiety and Depression Scale-Anxiety; HADS-D: Hospital Anxiety and Depression Scale-Depression; AOFAS: American Orthopaedic Foot & Ankle Society Forefoot Score; CSI: Central Sensitization Inventory; EQ-5D-5 L: EuroQol Five Dimensions Five Levels.

Figure 4 Correlation between surgical prognosis of group A patients and preoperative anxiety and depression. VAS: Visual Analogue Scale; CSI: Central Sensitization Inventory; EQ-5D-5 L: EuroQol Five Dimensions Five Levels.