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Case report: managing fractures in non-compliant alcoholic patients--a challenging task
C P Charalambous1, C S Zipitis, R Kumar
1Department of Trauma and Orthopaedics, Manchester Royal Infirmary, Manchester, UK.
Aims:
To investigate whether there are extractable conclusions for limb fracture management in dependent alcoholics.
Methods:
We discuss four cases of dependent alcoholics who presented in our department over a 12-month period, and who developed significant complications owing to non-compliance with treatment.
Results:
Initial treatment, although appropriate, failed because of non-compliance. This led to further admissions, wound infections and surgery to enable cure.
Conclusions:
Our case reports indicate that for upper limb fractures of the middle third of the humerus, non-operative treatment or internal fixation with out-patient detoxification is appropriate. Lower limb fractures, on the other hand, should be dealt with by external fixation and in-patient detoxification. It is imperative that the alcohol dependence is addressed if we are to decrease non-compliance.