Journal of Orthopaedic Trauma, cilt.39, sa.7, ss.339-344, 2025 (SCI-Expanded, Scopus)
OBJECTIVES:To investigate how substance use impacts fracture healing.METHODS:Design:Prospective study.Setting:Academic.Patient Selection Criteria:Male Wistar Albino rats (n = 64) weighing 250-300 g were used in this experimental study. Four groups (1 control and 3 experimental) consisted of 16 rats each. Outcome measures and comparisons: No substance was administered to the control group, while morphine (0.3 mg/kg), cannabis (1 mg/kg), and cocaine (2 mg/kg) were intraperitoneally administered to each experimental group, respectively, daily to induce addiction over 2 weeks, and this was continued for 6 weeks following the experimentally induced fracture. Fractures were induced in the mid-diaphyseal region of the right femur using bone shears through osteotomy after sedoanalgesia, including a control group at the end of the second week. The impact of substance abuse on fracture union was evaluated in terms of biomechanics, histopathology, and radiology.RESULTS:The mean radiological score was 2.3 ± 0.4 in the control group, 2.6 ± 0.6 in the morphine group, 1.7 ± 0.5 in the cocaine group, and 1.9 ± 0.4 in the cannabis group (P = 0.024). The mean histopathological scores in the cocaine and cannabis groups (4.0 ± 1.6 and 4.0 ± 2.0, respectively) were higher than those in the control and morphine groups (7.8 ± 0.7 and 7.0 ± 1.1, respectively) (P < 0.001). While the mean biomechanical score of the control and cannabis groups was similar (74.0 ± 6.2 and 66.2 ± 3.7), it was lower than that of the morphine and cocaine groups (50.1 ± 9.8 and 55.8 ± 11.9, respectively) (P = 0.001).CONCLUSIONS:This study specifically demonstrated that the use of cocaine and cannabis delayed fracture union. Therefore, substance use must be considered in cases of delayed fracture healing.