“…To our knowledge, the effect of opioid-induced hypogonadism on osseous healing in the acute fracture setting has not been examined. The literature shows that physiologic and supraphysiologic testosterone levels support osseous strength and healing and supplemental testosterone may improve fracture healing, particularly in hypogonadal models [5,13,16,19,21,22,28,31,32]. The testosterone suppression seen with opioidinduced androgen deficiency may be the driving mechanism behind fracture callus suppression seen with opioid administration.…”