Case report: Managing fractures in non-compliant alcoholic patients - A challenging task

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.