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
Vagus Nerve Stimulation (VNS) for Various Etiologies
What is it: Vagus nerve stimulation (VNS) is a medical treatment that uses a device to deliver electrical impulses to the vagus nerve, which runs on both sides of the body from the lower brain through the neck to the chest and stomach. The left vagus nerve is typically used for this procedure, as simulating…
Surgery & Hand Therapy Highlights for Dupuytren’s Disease
Dupuytren’s disease affects the fascia of the hand (Dupuytren’s fasciectomy hand). It is relatively common to encounter patients with Dupuytren’s condition, even if that is not the primary reason you are treating the patient. Patients often present with a nodule(s) in the palm of the hand, or they may even have a thickened cord running…
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…
Graded Motor Imagery in Hand Therapy
The 3 Stages of Graded Motor Imagery We’ve all heard of mirror box therapy, but do you know the details of how it works? There’s actually 3 stages involved that exercise the brain and take advantage of its plasticity. There is a great deal of evidence supporting these three stages and you can use them…
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.