Psychological and social adaptation trajectories following traumatic fracture surgery - Impact of traditional Chinese medicine mind-body interventions on return-to-work outcomes: A retrospective cohort study.

Traumatic fractures impose a substantial psychological burden beyond physical injury, significantly impacting occupational recovery. Traditional Chinese medicine (TCM) mind-body interventions offer holistic approaches to addressing biopsychosocial recovery dimensions; however, their effectiveness in facilitating psychological adaptation and return-to-work outcomes remains inadequately characterized. This study aims to evaluate the effects of integrated TCM mind-body interventions on psychological and social adaptation trajectories in post-surgical traumatic fracture patients and their association with return-to-work outcomes. This retrospective cohort study analyzed 404 patients (mean age 52.2 ± 13.3 years, 64.6% male; 202 TCM intervention, 202 control) who underwent surgical treatment for traumatic fractures at Nantong Third People's Hospital between 2020 to 2022. The TCM group received standard orthopedic care plus comprehensive mind-body interventions, including acupuncture, traditional exercises (Tai Chi/Qigong), mindfulness meditation, and herbal therapy. The control group received standard orthopedic care, including surgical treatment, structured physiotherapy, occupational therapy, multimodal pharmacological pain management, and systematic follow-up care. The primary outcomes included psychological adaptation trajectories assessed using the Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale, and Pain Catastrophizing Scale over 12 months. The secondary outcomes included return-to-work rates and healthcare utilization. Statistical analyses employed linear mixed-effects models, survival analysis, latent class growth analysis, and structural equation modeling. The TCM group demonstrated superior psychological adaptation, with significantly lower anxiety (4.3 ± 3.4 vs 7.2 ± 3.5, P < .001) and depression scores (3.9 ± 2.9 vs 6.8 ± 3.3, P < .001) at 12 months, representing large effect sizes (Cohen d = 0.84 and 0.94). Return-to-work rates were substantially higher (90.7% vs 72.9%, P < .001) with reduced median time to return (14.5 vs 22.0 weeks, hazard ratio = 1.58, 95% confidence interval: 1.24-2.01). Trajectory analysis revealed 37.4% of TCM patients achieved rapid psychological recovery versus 20.6% of controls (odds ratio = 2.31, 95% confidence interval: 1.41-3.78). Mediation analysis demonstrated that 53.8% of treatment effects were mediated through psychological improvements. Integrated TCM mind-body interventions significantly enhanced psychological and social adaptation trajectories, facilitating accelerated return-to-work outcomes. These findings support the integration of holistic approaches in orthopedic trauma care, addressing biopsychosocial recovery dimensions.