Objective: To investigate how substance use impacts fracture healing.
Methods: Male Wistar Albino rats (n=64) weighing 250-300 g were used in this experimental study. Four groups (one control and three experimental) consisted of 16 rats each. 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, rerspectively, daily to induce addiction over two weeks, and this was continued for six 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).
Conclusion: 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.
Keywords: Fracture healing; cannabis; cocaine; morphine; rats.
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