A systematic literature review and narrative synthesis on the risk factors for developing affective disorders in open lower-limb fracture patients

•Patients with strong social support have, in general, a lower risk of depression and psychological distress.•Poverty is a risk factor in general for psychological distress.•Negative affect may play an important role in determining physical function during the recovery period.•In most patients, symptoms of psychological distress improve over time.•Not all patients may display symptoms of psychological distress immediately post-injury.