{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T20:37:31Z","timestamp":1757623051226,"version":"3.44.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005366","name":"University of Oslo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005366","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Acute pain is common following orthopedic trauma and surgery. This study aims to evaluate the adequacy of pre- and postoperative pain management in traumatic fracture patients undergoing orthopedic surgery in Ethiopia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A prospective cohort study was conducted at two Ethiopian trauma centers from January 2019 to October 2021. Preoperatively, data was obtained on sociodemographic factors, substance use, type of injury, pain and psychological factors. Pain was assessed again 24\u00a0h following surgery. Pain management adequacy was evaluated using the Pain Management Index (PMI), based on the World Health Organization\u2019s pain treatment framework. The PMI was determined by subtracting the patient\u2019s pain intensity from the strength of the prescribed analgesic scores range from \u2212\u20093 to +\u20093. Negative values indicate inadequate pain control. <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 220 patients enrolled, 218 completed the study. Preoperative pain was inadequately managed in 74.8% of patients, improving to 42.2% postoperatively. Most patients reported mild (23.3%), moderate (43.1%), or severe (30.8%) pain preoperatively, yet 56.4% received no analgesics. At 24\u00a0h post-surgery, the patients reported mild (5.0%), moderate (53.7%), and severe (41.3%) pain, with 99.1% receiving analgesics. Notably, no patients with severe pain were given strong opioids at any time point. Lower educational level was associated with inadequate preoperative pain management (AOR: 3.18; 95% CI: 1.19\u20138.54). Alcohol use (AOR: 2.80; 95% CI: 1.30\u20136.05), higher anxiety (AOR: 1.17; 95% CI: 1.05\u20131.30), and higher depression scores (AOR: 0.77; 95% CI: 0.68\u20130.88) were associated with inadequate pain management 24\u00a0h post-surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Most patients with traumatic fractures received inadequate perioperative pain management, especially before surgery. Strong opioids were not used even in cases of severe pain. Socio-demographic and psychological factors were significantly associated with inadequate pain management.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00423-025-03837-y","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T06:13:57Z","timestamp":1755065637000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre- and postoperative pain management practices in fracture surgery: A bicentric prospective observational study in Ethiopia"],"prefix":"10.1007","volume":"410","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7029-8813","authenticated-orcid":false,"given":"Mestawet","family":"Getachew","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7144-5096","authenticated-orcid":false,"given":"Anners","family":"Lerdal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8373-5309","authenticated-orcid":false,"given":"Tsegaye","family":"Melaku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2074-2071","authenticated-orcid":false,"given":"Maren Falch","family":"Lindberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"issue":"9","key":"3837_CR1","doi-asserted-by":"publisher","first-page":"e580","DOI":"10.1016\/S2666-7568(21)00172-0","volume":"2","author":"A-M Wu","year":"2021","unstructured":"Wu A-M et al (2021) Global, regional, and National burden of bone fractures in 204 countries and territories,1990\u20132019: a systematic analysis from the global burden of disease study 2019. 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Written informed consent forms were obtained from all patients. For patients who were unable to read and\/or write, informed consent including a witness signature was obtained. The study was performed in accordance with the Declarations of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"246"}}