Fractures, whether intrinsic or extrinsic, account for 16 percent of all musculoskeletal injuries in the United States annually and are among the most common orthopedic problems.

In 1998, more than 10.7 million fractures were seen by physicians in office-based practices. Over half (57 percent) of these fractures result in hospitalizations, and approximately 3.5 million visits are made to emergency departments for fractures each year.

Bone breakage usually requires immediate and direct medical intervention. Although casts don't heal broken bones on their own, they hold the affected area in place so the body can heal itself naturally. However, cast room procedures generally cause anxiety in patients, which can further complicate the procedure and increase the risk of a complication.

That's where music comes in. Researchers have long been exploring how music therapy can improve health outcomes in a variety of patient populations, including premature infants and those with depression and Parkinson's disease.

In 2013, a study in JAMA Pediatrics on the link between music and stress found that music can help soothe pediatric emergency room patients. In a trial with 42 children, ages 3 to 11, researchers found that patients who listened to relaxing music while getting an intravenous (IV) line inserted reported significantly less pain, and some demonstrated significantly less distress, compared with patients who did not listen to music. In addition, in the music-listening group, more than two-thirds of the healthcare providers reported that the IVs were easy to administer, compared with 38 percent in the group who did not listen to music.

The aim of a new study in the journal Injury was to evaluate the effect of listening to music on adult patients in cast room procedures. The researchers focused on the relation between anxiety and anxiety-relevant cardiac arrhythmia.

The study included 199 patients with stable general conditions who were 18 years and older. The patients were divided into two groups. The randomization method used in the study was coin flip. The first group (Group 1) listened to music during cast room procedures, and the second group (Group 2) did not listen to music.

The researchers evaluated length of the procedure, complication, blood pressure and heart rate evaluations before and after the procedure, Visual Analogue Scale (VAS scores for pain), State-Trait Anxiety Inventory (STAI) anxiety score, patient satisfaction, willingness of the patient to repeat the procedure, P wave dispersion (Pd) and corrected QT interval dispersion (QTcd) as electrocardiographic arrhythmia predictors.

Significant difference was shown between the two groups for VAS scores, anxiety scores, processing time and QTcd values. Patient satisfaction and willingness to repeat the procedure were higher for the group who listened to music. No significant differences in Pd values, blood pressure and heart rate were reported within the groups.

These results suggest that music therapy is a noninvasive, safe, nonpharmacologic treatment that should become standard protocol in cast room procedures. Importantly, this study shows that music decreases anxiety and anxiety-related cardiac arrhythmia and suggests the need for further prospective studies to include high cardiac risk patients.