We reviewed the initial history, obtained by the orthopaedic house
staff, of each of eighty-seven patients who were consecutively admitted to
an acute orthopaedic-surgery service. A diagnosis of alcoholism was made by
the house staff in only one of every ten patients who had been identified
as having symptoms of alcohol addiction in a previous study. Alcohol abuse
was identified in only five of every ten such patients. Of the orthopaedic
patients in this sample who had been shown to be abusing alcohol, 37 per
cent were neither suspected nor diagnosed as abusers by the orthopaedic
house staff. We recommend the use of a brief screening interview (CAGE) to
increase diagnostic effectiveness in this area, and discuss the clinical
usefulness of an early diagnosis of alcoholism among orthopaedic surgical
patients.