Nature and healing of tibial shaft fractures in alcohol abusers

Alcohol abuse is associated with an increased risk of osteopenia and fractures. Previous histomorphometric studies on iliac crest bone have found decreased bone formation and increased bone resorption in alcohol abusers but it has not been established whether alcohol abuse has any effect on the anatomical location or the healing time of tibial shaft fractures. We studied, retrospectively, 199 adult male patients hospitalized for isolated tibial shaft fracture in the city of Malmö, Sweden, between 1980 and 1990. Forty-nine of the patients had earlier been registered at the Department of Alcohol Diseases and were judged to be problem drinkers. Abusers sustained their tibial shaft fractures more often by falling at ground level (P < 0.0001) or from a higher level (P = 0.009) and the fractures were more often oblique than transverse (P = 0.002) as compared with non-abusers. Healing time was impaired in abusers who had sustained a transverse fracture (P = 0.035), but no difference was observed in healing time in those with a oblique fracture. We found no difference between the abusers and the non-abusers regarding duration of hospital stay, fracture location, amount of displacement, occurrence of open fractures or the rate of complications.