Alcohol is one of most commonly abused substances in the United States, and it has contributed to a growing epidemic of medical ailments, including cirrhosis, neurologic and psychosocial disorders, impairment to fertility, and cancer. Moreover, acute and chronic alcohol use represent a significant risk factor for orthopaedic injury and postoperative complications. Yet, relatively little is known about the clinical implications of alcohol abuse in common orthopaedic procedures. Acute withdrawal from alcohol is potentially fatal, particularly in the orthopaedic inpatient whose abstinence is mandated by the hospital setting. The aim of this review is to address the screening, diagnostic, and therapeutic tools available to appropriately manage acute alcohol withdrawal in the orthopaedic inpatient. The influence of chronic alcohol consumption on bone metabolism, fracture healing, and surgical fixation will also be reviewed because this information may guide surgical decision making.
From the UC Irvine Department of Orthopaedic Surgery, Irvine, CA (Dr. Lim and Dr. Gupta), the Department of Orthopaedic Trauma, Saint Alphonsus Health System, Boise, ID (Dr. Zamorano), and the Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA (Dr. Haghverdian).
Dr. Zamorano or an immediate family member serves as a paid consultant to Smith & Nephew. Dr. Gupta or an immediate family member serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, The American Society for Surgery of the Hand, and the American Shoulder and Elbow Surgeons. None of the following authors nor any immediate family member have received anything of value from or have stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Lim and Dr. Haghverdian.