{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:58Z","timestamp":1787755858116,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 17-year-old man presented with an unstable C5 flexion-compression injury and bilateral comminuted distal radius fractures after a motorcycle collision. Despite standard opioid therapy, he experienced difficulty with pain control during and after treatment. Genetic testing revealed a polymorphism in the cytochrome P450 2D6 (CYP2D6) gene, resulting in ultrarapid metabolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Genetic mutations in CYP2D6 can result in impaired opioid metabolism and impaired pain control. Impaired pain control in musculoskeletal trauma patients should raise concern for a potential CYP2D6 mutation. A proper understanding of this condition and adjustments in pain management can guide optimal care for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00430","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T19:00:11Z","timestamp":1764874811000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Opioid Hypermetabolism in a Multiextremity Spine Trauma Patient"],"prefix":"10.2106","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5850-939X","authenticated-orcid":false,"given":"Stephen","family":"Fanous","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Mercy Hospital, Kansas City, Missouri"},{"name":"University of Kansas Medical Center, Kansas City, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5862-6243","authenticated-orcid":false,"given":"Zach","family":"Denton","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center, Kansas City, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1638-1037","authenticated-orcid":false,"given":"Nicolette","family":"Saddler","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1365-2488","authenticated-orcid":false,"given":"Anne","family":"Stuedemann","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2866-1500","authenticated-orcid":false,"given":"John T.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3553-2889","authenticated-orcid":false,"given":"K. Aaron","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10]]},"reference":[{"issue":"7","key":"bib1-20260204","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0025-6196(11)60750-7","article-title":"Opioid metabolism","volume":"84","author":"Smith","year":"2009","journal-title":"Mayo Clinic Proc."},{"issue":"6 suppl","key":"bib2-20260204","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/j.jpainsymman.2012.08.012","article-title":"The clinical implications of cytochrome P450 interactions with opioids and strategies for pain management","volume":"44","author":"Brennan","year":"2012","journal-title":"J Pain Symptom Manage."},{"issue":"7","key":"bib3-20260204","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1097\/PEC.0b013e3181e5c02b","article-title":"Pain management of musculoskeletal injuries in children: current state and future directions","volume":"26","author":"Ali","year":"2010","journal-title":"Pediatr Emerg Care."},{"key":"bib4-20260204","doi-asserted-by":"crossref","first-page":"100266","DOI":"10.1016\/j.tcr.2019.100266","article-title":"Application of pharmacogenomics for trauma and critical care patients: a case report","volume":"24","author":"McFadgen","year":"2019","journal-title":"Trauma Case Rep."},{"issue":"11","key":"bib5-20260204","doi-asserted-by":"crossref","first-page":"e2042","DOI":"10.1002\/onco.13953","article-title":"Impact of CYP2D6 pharmacogenomic status on pain control among opioid-treated oncology patients","volume":"26","author":"Reizine","year":"2021","journal-title":"Oncologist."},{"key":"bib6-20260204","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.2147\/JPR.S315585","article-title":"The American Society of Pain and neuroscience (ASPN) best practices and guidelines for the interventional management of cancer-associated pain","volume":"14","author":"Aman","year":"2021","journal-title":"J Pain Res."},{"issue":"27","key":"bib7-20260204","doi-asserted-by":"crossref","first-page":"2827","DOI":"10.1056\/NEJMoa041888","article-title":"Codeine intoxication associated with ultrarapid CYP2D6 metabolism","volume":"351","author":"Gasche","year":"2004","journal-title":"N Engl J Med."},{"issue":"1","key":"bib9-20260204","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1053\/eujp.1999.0147","article-title":"Neuronal inhibitory effects of methadone are predominantly opioid receptor mediated in the rat spinal cord in vivo","volume":"4","author":"Carpenter","year":"2000","journal-title":"Eur J Pain."},{"issue":"27","key":"bib10-20260204","doi-asserted-by":"crossref","first-page":"2827","DOI":"10.1056\/NEJMoa041888","article-title":"Codeine intoxication associated with ultrarapid CYP2D6 metabolism","volume":"351","author":"Gasche","year":"2004","journal-title":"N Engl J Med."},{"issue":"4","key":"bib11-20260204","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/cpt.2149","article-title":"Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT genotypes and select opioid therapy","volume":"110","author":"Crews","year":"2021","journal-title":"Clin Pharmacol Ther."}],"updated-by":[{"DOI":"10.2106\/jbjs.cc.er.25.00430","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000}}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.25.00430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:54:57Z","timestamp":1787752497000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.25.00430"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.25.00430","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}