Wrist Fractures and Marijuana Use: What are the complications?

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

• 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.