Special Considerations in the Orthopaedic Trauma Patient: Curbing Negative Social Behaviors

Optimizing the orthopaedic trauma patient for surgical intervention presents unique challenges. Due to the acute nature of musculoskeletal injuries and time constraints for treatment, there is a limited window for overall patient comorbidity optimization prior to surgical fracture repair. Certain social behaviors including tobacco use, excessive alcohol consumption, and inappropriate opioid medication usage can have a negative impact on wound and fracture healing. Curbing such negative social behaviors can have a positive outcome on patients who are affected by musculoskeletal trauma. Addressing these challenging issues, via available resources, can have a significant impact on recovery after sustaining orthopaedic trauma. A tactical approach focused on relationship building with patients and their families as well as highlighting strategies to curb negative social behaviors is presented involving a patient with an infected tibial nonunion.