Influence of Alcohol Consumption in the Fracture Healing Process
Authors: MARINA Virginia , DIMOTE Florentin 
Published: February 2022

Abstract
This study presents the impact of alcohol addiction in the treatment of fractures following alcohol withdrawal.The study was done on patients from the region of Moldova, Romania and admitted to the orthopedics-traumatology department. The Moldavian region of Romania is famous for its wine-growing areas and the quality of its wines (internationally renowned vineyards are: Cotnari, Odobesti, Panciu Husi) and is therefore a region with high alcohol consumption. The study presentation: The study carried out in the orthopaedics-traumatology clinic of the Emergency Clinical Hospital « Sf. Andrei » of Galati, was conducted over a period of 5 years, 2015-2019, on a group of 510 patients. Of the 510 patients admitted, the 215 patients had different types of fractures of the upper limb and the remaining 295 patients had different types of fractures of the lower limb but also fractures of the pelvis. The welded group was composed of the follows: the 435 patients were male and the 75 female.The vast majority of these patients were from the rural areas, 422 patients.In terms of social class, the 35 patients had higher education, the 411 patients had secondary education and the 74 patients had elementary or no education. The most affected age of the patients with the withdrawal syndrome was in the 40-50 age group (131 patients) and 51-60-year-old (203 patients). 88 of the patients were spirits drinkers (especially « ţuică » Romanian spirit drink), 245 of the patients were the wine drinkers, 99 patients were the beer drinkers and 78 patients were the drinkers of any alcoholic beverage. Discussions: Of the 105 patients who developed sudden alcohol withdrawal in the first 48 hours, 35 patients were consumers of any type of alcoholic beverage, 46 patients were the wine drinkers and 24 were the beer drinkers.Due to the rapid onset of withdrawal of the 105 patients, we were able to perform emergency surgery on only the 45 patients, while the remaining the 65 patients developed early alcohol withdrawal, which necessitated a delay in surgery, temporary immobilization of the fracture and subsequent transfer to the psychiatric hospital for the specialized treatment. Of the 65 patients who were transferred, the 30pacients had fractures where the temporary immobilization could be performed. Of the 30 patients who were immobilized in different types of plaster casts, the 15 patients returned with damaged plaster casts or even without immobilization.The alcohol withdrawal generally starts about 48 hours after the abstinence and depends by the social class, the age and the type of alcohol consumed by the patient. The most severe types of the withdrawal were to the patients 51-60 -year-old, from the rural areas with the elementary education and the consumers of wine and beer. To this is added poor nutrition. The patients who were more easily withdrawn were those with higher education, well nourished, mainly consumers of beer or wine. They came out of the withdrawal relatively easily either with less the alcohol consumption or with the vitamin therapy and did not require the transfer to a psychiatric ward. At the opposite end of the spectrum are patients about 50-60 -year-old, from rural areas, who drink 2-3 liters of wine or beer a day, without much education.Conclusion: The patients with the possible decomposition through the alcohol withdrawal should be diagnosed at the admission and treated early with the metabolic support, the vitamin therapy and the hypnotics so that they do not the trigger alcohol withdrawal. In some cases, the delay of the surgery due to the early onset of the withdrawal, the long-term surgical and the functional outcomes have been shown to be unsatisfactory for the patient.