{
  "abstract": "Background and purpose\n\nDiaphyseal humerus fractures may lead to prolonged pain medication use. We aimed to study pain medication use after such fractures, focusing on nerve injury.Methods\n\nUsing Swedish register data (2007-2015), we identified individuals with diaphyseal humerus fractures. High use of opioids and neuropathic pain medication (≥ 60% of days covered/year; 2-month post-fracture washout) was evaluated in 5 groups: the general population (reference) and fractures treated nonoperatively or surgically, with and without nerve injury. Relative risks (RRs; 95% confidence intervals [CIs]; crude and adjusted [aRR] models; adjusted for age, sex, country of birth, income, and cohabitation status; and for previous high use of pain medication during the first year when analyzing the second year) were estimated in Cox proportional hazards regression models.Results\n\nWe identified 4,185 individuals with diaphyseal humerus fractures (3.7% with nerve injury; 23% surgically treated). In the first year, opioid use was higher among surgically treated fractures with nerve injury (aRR 17.6, CI 11.0-28.3) and without nerve injury (aRR 9.5, CI 8.2-10.9) than in the general population. In the second year, opioid use declined across most groups but remained elevated among nonoperatively treated fractures with nerve injury (aRR 8.3, CI 2.6-26.1). Neuropathic pain medication use increased in the first year, with no elevated use in the second. Adjustment did not change overall patterns. Women, older adults, lower-income individuals, and those living alone showed higher medication risk use.Conclusion\n\nPatients with a diaphyseal humerus fracture were associated with a substantial burden of pain medication use, particularly for opioids during the first year post-injury in surgically treated fractures with nerve injury (RR 17.6) and a persistent risk in the second year among nonoperatively treated fractures with nerve injury (RR 8.3). Demographics and socioeconomic factors strongly relate to medication use, highlighting the need for careful early pain management and monitoring for prolonged medication use in exposed groups.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro; Clinical Department of Hand Surgery, Plastic Surgery and Burns, Region Östergötland, Linköping University Hospital, Linköping; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. erika.nyman@liu.se.",
    "Department of Orthopedics, Kalmar Hospital, Kalmar, Sweden.",
    "Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö; Unit for Social Epidemiology, Department of Clinical Sciences (Malmö), Faculty of Medicine, Lund University, Malmö, Sweden.",
    "Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö; Department of Orthopedics, Helsingborg Hospital, Helsingborg, Sweden.",
    "Unit for Social Epidemiology, Department of Clinical Sciences (Malmö), Faculty of Medicine, Lund University, Malmö; Center for Primary Health Research, Region Skåne, Malmö, Sweden.",
    "Department of Biomedical and Clinical Sciences, Linköping University, Linköping; Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Erika Nyman"
    },
    {
      "affs": [
        1
      ],
      "name": "Simone Andersson"
    },
    {
      "affs": [
        2
      ],
      "name": "Raquel Perez"
    },
    {
      "affs": [
        3
      ],
      "name": "Malin Zimmerman",
      "orcid": "0000-0002-9925-3838"
    },
    {
      "affs": [
        4
      ],
      "name": "Juan Merlo"
    },
    {
      "affs": [
        5
      ],
      "name": "Lars B Dahlin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5echvpk04hp2g.bib",
  "cited_by": 0,
  "doi": "10.2340/17453674.2026.46808",
  "fulltext_url": "https://europepmc.org/articles/PMC13721846",
  "id": "5echvpk04hp2g",
  "issns": [
    "1745-3674",
    "1745-3682"
  ],
  "landing_url": "https://europepmc.org/article/MED/42961444",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2739|Opioid Use Disorder Treatment"
    ]
  ],
  "openalex": "W7224784709",
  "pdf_url": "https://europepmc.org/articles/PMC13721846?pdf=render",
  "pmcid": "PMC13721846",
  "pmid": "42961444",
  "published": "2026-10-30",
  "publisher": "Nordic Orthopaedic Federation",
  "ris": "https://research.draconitic.com/paper/5echvpk04hp2g.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T03:21:21Z",
      "native_id": "MED:42961444",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42961444"
    },
    {
      "first_seen": "2026-11-03T12:22:28Z",
      "native_id": "PMC13721846",
      "source": "pmc",
      "url": "https://doi.org/10.2340/17453674.2026.46808"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Opioid Use Disorder Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Long-term use of opioids and neuropathic medication after diaphyseal humerus fractures with or without nerve injury: a nationwide register-based cohort study of 4,185 patients.",
  "title_text": "Long-term use of opioids and neuropathic medication after diaphyseal humerus fractures with or without nerve injury: a nationwide register-based cohort study of 4,185 patients.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:28Z",
  "url": "https://research.draconitic.com/paper/5echvpk04hp2g",
  "venue": "Acta orthopaedica",
  "versions": []
}