Abstract
OBJECTIVE: This study aimed to investigate the influence of ambient noise levels on postoperative psychological state, ankle function, and quality of life in individuals who underwent ankle fracture surgery, thereby offering scientific support for optimizing the postoperative rehabilitation environment. METHODS: A retrospective analysis of 123 patients (55 in the high-noise group, ≥ 55 dB; 68 in the low-noise group, < 55 dB) who underwent open reduction and internal fixation from January 2022 to March 2023. Assessments included the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), American Orthopaedic Foot and Ankle Society (AOFAS), and Olerud-Molander Ankle Score (OMAS). Statistical analyses included non-parametric tests, Spearman's correlation, and adjusted analyses (analysis of covariance and multivariate regression), controlling for confounders. RESULTS: Unadjusted analyses showed that the high-noise group had significantly higher SAS (40.41 ± 4.25 vs. 35.15 ± 3.61, P < 0.001) and SDS scores (46.55 and S vs. 42.63 and S, P < 0.001) but lower AOFAS (65.47 ± 6.45 vs. 69.71 ± 6.94, P < 0.001) and OMAS scores (64.47 ± 6.78 vs. 69.27 ± 7.37, P = 0.005). After this study adjusted for confounders, these differences remained significant (adjusted mean differences: SAS = 5.23, SDS = 9.89, AOFAS = -4.19, OMAS = -4.76, all P < 0.05). Noise levels were moderately positively correlated with anxiety (r = 0.376, P = 0.021) and negatively correlated with ankle function (r = -0.271, P = 0.002), with similar associations in multivariate regression (SAS: β = 0.352, P = 0.028; AOFAS: β = -0.214, P = 0.023). CONCLUSION: High-noise environments exacerbate postoperative anxiety, delay functional recovery, and reduce quality of life. Clinicians should optimize rehabilitation environments and adopt multidisciplinary interventions to improve outcomes.