Wrist Fractures and Marijuana Use: What are the complications?
Filed under Treatments
Title: Marijuana use and complications with healing after distal radius wrist fracture
Article:
Livesey, M. G., Bains, S. S., Stern, J. M., Chen, Z., Dubin, J. A., Monárrez, R., … & Ingari, J. V. (2025). Cannabis use in patients with distal radius fractures: a moment of unity?. Hand, 20(2), 263-268.
The skinny
The impact of tobacco use on surgical outcomes is well documented, no prior studies investigate the impact of cannabis (marijuana) use on long term surgical outcomes, This study compared the 1-year surgical complication rate of nonunion, malunion and surgical site infection between (1) non smokers, (2) cannabis smokers and (3) those who smoke both tobacco and cannabis.
Because the same receptors utilized by cannabis also affect bone cell function, bone turnover and bone mass, this study sought to identify any negative impact of cannabis use on bone healing post-operatively.
In the weeds
A national all-payer database was sampled between 2015 and 2020 with sample size decreased to a random sampling of 20,000 patients from each cohort was used to improve the accuracy of the multivariable regression model. Smokers were defined as those that smoke for 1 year prior and 1 year after surgery.
Bringing it home
| Tobacco only | Cannabis only | Tobacco & cannabis | Non-smokers | |
| Nonunion | 3.8% | 2.3% | 5% | 1.1% |
| Malunion | 3.4 | 2.2% | 3.8% | 1% |
| Site Infection | 0.57% | * | 0.62% | 0.09% |
- The small number of subjects in this category prevented reporting this value
Through statistical analysis of Odds Ratios (OR), the use of tobacco and cannabis had a significant impact on the occurrence of nonunion, malunion and site infection. The use of cannabis alone had a statistically significant impact on the rate of malunion and infection, but nonunion risk factors were not significantly elevated given the sample size.
Rating
4 out of 5
The use of a national database for data collection allowed for large sample sizes, but it also requires accurate reporting of the related information recorded in the database. The data available also did not indicate the rate or frequency of consumption of tobacco or cannabis.
Regardless, the immunosuppressive effects of cannabis has direct impact on infection rate and the use of the same receptors for bone cell function and bone turnover affect malunion and nonunion.
More To Read
Increasing Shoulder Range of Motion by improving Scapulohumeral Rhythm
Scapulohumeral rhythm is often the key component when treating shoulder conditions and the reason for the lack of total shoulder range of motion. This may also be a critical component in order to prevent shoulder conditions during rehabilitation of other upper extremity conditions such as distal radius fractures, tendon injuries, and elbow injuries. Scapulohumeral rhythm…
Ways to Improve HEP Compliance in Hand Therapy
Ways to Improve HEP Compliance in Hand Therapy By: Dalton Busch One of the most important ways we see our patient’s progress is by assuring they are compliant with their prescribed home exercise program (HEP). Our patients are always encouraged to adhere to their prescribed program but compliance is easier said than done. Reminding patients…
Prevention and Management of Upper Extremity injuries in Modern Mass Production
Injuries and Upper Extremty Pitts, G., Custer, M., Foister, R. D., & Uhl, T. (2021). The hand therapist’s role in the preventionand management of upper extremity injuries in the modern mass production industrial setting.Journal of Hand Therapy, 34(2), 237–249. https://doi.org/10.1016/j.jht.2021.04.019 By: Kaylen Kallander The Skinny: This study included four case studies to determine the impact…
Ultrasound use for reducing pain: Does it work?
Ilter, L., Dilek, B., Batmaz, I., Ulu, M.A., Sariyildiz, M.A., Nas, K., & Cevik, R. (2015). Efficacy of pulsed and continuous therapeutic ultrasound in myofascial pain syndrome: A randomized controlled study. American Journal of Physical Medicine & Rehabilitation, 94(7), 547-554. https://doi.org/10.1097/PHM.0000000000000210 Review by: Megan Prather The Skinny- Ultrasound hand therapy – ultrasound has been determined…
Sign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.