Opioids may raise risk of fracture nonunion

Chronic use of certain medications like opioids, a pain relieving drug may be a significant and substantial risk factor for fracture nonunion.

Nonunion is a serious complication of a fracture and may occur when the fracture moves too much, or has a poor blood supply or gets infected.

Patients who smoke have a higher incidence of nonunion.

A study conducted by researchers at Louisiana State University suggests that opioid-naive patients receive an opioid prescription for post-operative pain control at hospital discharge after major surgery. Yet they report there is no evidence that opioids are more effective than non-opioids for acute extremity pain.

"Chronic opioid use roughly doubled the risk of nonunion among all patients, and this effect was fairly consistent across all ages and both genders," noted Dr. Zura, a researcher.

The researchers reported that Schedule II opioids, as a group, create a greater nonunion risk than non-opioid analgesics. They also suggested that chronic use of certain medications may be a significant and substantial risk factor for fracture nonunion.

Opioid-naive patients receive an opioid prescription for post-operative pain control at hospital discharge after major surgery. Yet there is no evidence that opioids are more effective than non-opioids for acute extremity pain.

The study concluded that there is an inherent risk in use of most opioid analgesics and emphasize the importance of multimodal, non-opioid analgesic techniques at fracture.

The findings are published in the Journal of Injury.