559 Can Poller Screws Decrease Pain Relief in Femoral Fractures?

Abstract

Abstract Aim Poller screws, used alongside intramedullary (IM) nails for femoral shaft fractures, aim to expedite healing and minimize complications by enhancing fracture stability and controlling IM nail insertion. Despite their benefits, the impact of poller screws on post-operative pain is understudied. This retrospective cohort study aimed to compare opioid medication needs in femoral shaft fractures managed with IM nails with and without poller screws. Method Between January 2015 and December 2022, a retrospective analysis was conducted on femoral shaft fractures treated at a major trauma centre. Patients primarily treated with IM nails were included. Patient and operation notes, along with radiographs, identified poller screw utilization and categorized screw generation. Opioid medication data, converted to "coverage" (days) and "strength" (morphine milligrams equivalent or MME), was collected. Two-tailed independent samples T-tests compared patients treated with (n=43) and without poller screws (n=364). Results Second-generation poller screws significantly reduced opioid strength requirements in the first post-operative year (603.6 vs. 1711.6 MME, p=0.03), except the first month. However, no significant difference was observed in the number of days with opioid prescriptions throughout the first post-operative year for each poller screw generation. Conclusions This study highlights the potential of poller screws in reducing post-operative pain in femoral fractures. Future endeavors aim to use a larger patient sample, but these results signify the promise of poller screws in mitigating post-operative pain in IM-treated femoral fractures.