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Alcohol and Alcoholism Vol. 38, No. 4, pp. 357-359, 2003
© 2003 Medical Council on Alcohol

CASE REPORT: MANAGING FRACTURES IN NON-COMPLIANT ALCOHOLIC PATIENTS — A CHALLENGING TASK

C. P. Charalambous*, C. S. Zipitis, R. Kumar, P. Hirst and A. S. Paul

Department 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.


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