Osteoporosis en alcoholismo crónico : un problema infravalorado. Incidencia y complicaciones de las fracturas en el paciente alcohólico

Abstract

Main goal. To estimate the incidence of pathologic fractures and associated complications in patients in follow-up for moderate to severe chronic alcoholism by the Unidad de Conductas Adictivas (UCA) of our health area. To highlight the importance of recognizing osteoporosis in patients with chronic alcoholism in order to establish strategies for prevention of both primary and secondary fractures. Material and methods. Retrospective analysis of patients in follow-up for chronic alcoholism by the UCA between 2014 and 2018 that required assessment by the Orthopedics Unit for fractures during that period, excluding fractures in the context of politraumatism. In addition, the complications derived from these fractures were collected and it was determined whether bone densitometry (BMD) was indicated following the main osteoporosis guidelines. Results. The incidence rate of fractures due to low-energy trauma in the selected population during the follow-up period was 7.2 for every 1,000 patients / year. 41% of the 44 study patients suffered new fractures during this period. 33% of the patients with fractures that required surgical treatment suffered major complications. 100% of the patients fulfilled criteria for BMD after the first traumatic event, despite only 20% of them being ultimately performed. Conclusions. The prevalence of fractures and associated complications in alcoholic patients is significantly higher than in the general population. It is necessary to stress the importance of both primary and secondary prevention of pathologic fractures in alcoholic patients, and if they occur, osteosynthesis techniques adapted to an osteoporotic bone should be applied

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