AI Article Synopsis

  • Patients recovering from lower extremity fractures have an increased risk of chronic opioid use, with certain fracture types showing higher percentages of users post-surgery.
  • A meta-analysis reviewed 732 articles, and after applying selection criteria, 9 studies were analyzed to assess opioid use six months after surgery.
  • Bicondylar and unicondylar tibial-plateau fractures had the highest rates of chronic opioid use (29.7-35.2%), while opioid-naive patients showed significantly lower usage rates compared to those with prior opioid use.

Article Abstract

Introduction:  Patients recovering from musculoskeletal trauma have a heightened risk of opioid dependence and misuse, as these medications are typically required for pain management. The purpose of this meta-analysis was to examine the association between fracture type and chronic opioid use following fracture fixation in patients who sustain lower extremity trauma.

Materials And Methods: A meta-analysis was performed using PubMed and Web of Science to identify articles reporting chronic opioid use in patients recovering from surgery for lower extremity fractures. 732 articles were identified using keyword and MeSH search functions, and 9 met selection criteria. Studies were included in the final analysis if they reported the number of patients who remained on opioids 6 months after surgery for a specific lower extremity fracture (chronic usage). Logistic regressions and descriptive analyses were performed to determine the rate of chronic opioid use within each fracture type and if age, year, country of origin of study, or pre-admission opioid use influenced chronic opioid use following surgery.

Results: Bicondylar and unicondylar tibial-plateau fractures had the largest percentage of patients that become chronic opioid users (29.7-35.2%), followed by hip (27.8%), ankle (19.7%), femoral-shaft (18.5%), pilon (17.2%), tibial-shaft (13.8%), and simple ankle fractures (2.8-4.7%).Most opioid-naive samples had significantly lower rates of chronic opioid use after surgery (2-9%, 95% CI) when compared to samples that allowed pre-admission opioid use (13-50%, 95% CI). There were no significant associations between post-operative chronic opioid use and age, year, or country of origin of study.

Conclusions:  Patients with lower extremity fractures have substantial risk of becoming chronic opioid users. Even the lowest rates of chronic opioid use identified in this meta-analysis are higher than those in the general population. It is important that orthopedic surgeons tailor pain-management protocols to decrease opioid usage after lower extremity trauma.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00402-023-05174-5DOI Listing

Publication Analysis

Top Keywords

chronic opioid
36
lower extremity
24
opioid
14
chronic
10
extremity fracture
8
fracture type
8
opioid fracture
8
extremity fractures
8
age year
8
year country
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!