Association Between Early Opioid Prescribing and New Persistent Use After Distal Radius Fracture: A Retrospective...

Area of Science:

• Orthopaedic surgery
• Pain management
• Pharmacology

Background:

• Distal radius fractures (DRFs) are common and often require surgery.
• Opioids are frequently used for postoperative pain but carry risks, especially for opioid-naïve patients.
• Concerns exist regarding new persistent opioid use after surgery.

Purpose of the Study:

• To investigate if early postoperative opioid prescribing increases the risk of new persistent opioid use in opioid-naïve patients undergoing DRF surgery.
• To evaluate the association between early opioid use and persistent upper extremity pain.

Main Methods:

• Retrospective cohort analysis using the TriNetX database.
• Stratification of opioid-naïve patients into opioid and no-opioid groups based on postoperative prescriptions.
• Propensity score matching to control for confounding variables.

Main Results:

• Early opioid prescription was linked to a significantly higher risk of new persistent opioid use (4.2% vs. 1.4%).
• Increased rates of persistent forearm, hand, or finger pain (1.0% vs. 0.6%) and wrist pain (5.8% vs. 3.8%) were observed with early opioid use.
• No significant differences in mortality or new mental health disorders were found.

Conclusions:

• Early opioid prescribing after DRF surgery is associated with new persistent opioid use and persistent upper extremity pain.
• Findings suggest a need for careful opioid prescribing and exploration of alternative pain management strategies.
• Reducing prolonged opioid utilization is a key consideration in postoperative pain management for DRFs.