The Influence of Opioid Use Disorder on Open Reduction and Internal Fixation Following Ankle Fracture

Megan K. Allen, James M. Parrish, Rushabh Vakharia, Jonathan R.M. Kaplan, Ettore Vulcano, Martin W. Roche, Amiethab A. Aiyer

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background. Ankle fractures are common and may require open reduction and internal fixation (ORIF). Literature is scarce evaluating the associations of opioid use disorder (OUD) with ORIF postoperative outcomes. This study investigates whether OUD patients have increased (1) costs of care, (2) emergency room visits, and (3) readmission rates. Methods. ORIF patients with a 90-day history of OUD were identified using an administrative claims database. OUD patients were matched (1:4) to controls by age, sex, and medical comorbidities. The Welch t-test determined the significance of cost of care. Logistic regression yielded odds ratios (ORs) for emergency room visits and 90-day readmission rates. Results. A total of 2183 patients underwent ORIF (n = 485 with OUD vs n = 1698 without OUD). OUD patients incurred significantly higher costs of care compared with controls ($5921.59 vs $5128.22, P <.0001). OUD patients had a higher incidence and odds of emergency room visits compared with controls (3.50% vs 0.64%; OR = 5.57, 95% CI = 2.59-11.97, P <.0001). The 90-day readmission rates were not significantly different between patients with and without OUD (8.65% vs 7.30%; OR = 1.20, 95% CI = 0.83-1.73, P =.320). Conclusion. OUD patients have greater costs of care and odds of emergency room visits within 90 days following ORIF.

Original languageEnglish
Pages (from-to)232-237
Number of pages6
JournalFoot and Ankle Specialist
Issue number3
StatePublished - Jun 2021


  • ankle injuries
  • external and internal fixation
  • hospital practice
  • medical-legal issues in pain management
  • pain management


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