Case report: managing fractures in non-compliant alcoholic patients--a challenging task.
OBJECTIVE
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.
Charalambous
C P
CP
Department of Trauma and Orthopaedics, Manchester Royal Infirmary, Manchester, UK.
Zipitis
C S
CS
Kumar
R
R
Hirst
P
P
Paul
A S
AS
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D016512:Ankle Injuries / Q000209:etiology / Q000523:psychology / Q000628:therapy; D019468:Disease Management; D050723:Fractures, Bone / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D006810:Humeral Fractures / Q000209:etiology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016312:Treatment Refusal / Q000523:psychology*