The "battered alcoholic syndrome".

The Battered Alcoholic Syndrome is here defined by the presence of three or more fractures in the same individual but in differing chronological stages of healing. These may be identified either on the basis of radiographs or by history. Because only three per cent of alcoholics are of the skid-row stereotype, and because the treatment of an alcoholic may differ from that of a nonalcoholic, the recognition of this syndrome is of value in the initial and long-term management of such individuals. In 100 consecutive fracture patient admissions at Harborview Medical Center the incidence of this syndrome in Seattle was eight per cent of fracture patients admitted to the hospital; 62% of patients with a third discrete fracture were alcoholics. Etiologic factors which may play a role in its development include greater exposure to trauma, psychologic predisposition, nutritional depletion, and the direct toxic effects of alcohol itself.