Affiliation:
1. Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University Hospital Tehran University of Medical Sciences Tehran Iran
Abstract
AbstractPurposeIllicit drug abuse is a global epidemic afflicting millions worldwide. Several studies have investigated the contribution of this dependence as a risk factor for fracture, but its impacts on fracture severity have been rarely studied. The present study primarily aims to determine the relationship between illicit drug abuse and the severity of tibial shaft fractures.MethodsThis retrospective study consecutively included patients aged ≥18 years with tibial shaft fracture who attended Sina Tertiary Hospital, Tehran, Iran, between 2016 and 2021. The fracture patterns were assessed according to the Arbeitsgemeinschaft für Osteosynthesefragen Foundation/Orthopaedic Trauma Association classification. Participants were divided into three individual specialists into groups: simple (A), wedge (B) and multifragmentary (C) fractures. The association of illicit drug abuse and other recorded variables, including age, sex, body mass index (BMI), comorbidities, physical activity, smoking habits and mechanism of injury, was also examined and assessed in multivariate logistic regression.ResultsOf 219 patients, 26 were drug abusers, and 193 had no history of use. A total of 20 out of 26 drug abusers experienced a complex fracture, yielding a rate of 76.9%, while this rate for nonusers was 50.3% (97 out of 193), indicating a statistically significant difference between the two subgroups (p = 0.011). The smoking history also influenced the fracture pattern (p = 0.027) based on univariate analysis; however, using adjusted multivariate analysis yielded only illicit drug abuse (odds ratio = 3.495; confidence interval = 1.144–10.680) as a risk factor for more complex fractures.ConclusionThe evidence from this study suggests that complexity and fracture patterns can depend on illicit drug abuse history.Level of EvidenceLevel III.
Subject
Orthopedics and Sports Medicine
Reference38 articles.
1. The epidemiology of open long bone fractures
2. Health care and productivity costs for isolated tibia shaft fracture admissions in the Netherlands;Leliveld M.S.;Acta Orthopaedica Belgica,2020
3. Epidemiology of adult tibial shaft fractures: a 7‐year study in a major referral orthopedic center in Iran;Madadi F.;Medical Science Monitor: International Medical Journal of Experimental and Clinical Research,2010
4. Incidence and epidemiology of tibial shaft fractures
5. Fracture risk associated with the use of morphine and opiates