Marijuana Use and Complication Risk After Tibia Shaft Fracture Fixation

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Pharmacology

Background:

• Tibia shaft fractures are common injuries requiring surgical fixation.
• The increasing prevalence of marijuana use necessitates understanding its impact on surgical outcomes.
• Previous research on marijuana's effect on orthopedic surgery complications is limited.

Purpose of the Study:

• To investigate the association between preoperative marijuana use and postoperative complications following tibia shaft fracture fixation.
• To analyze the risk of surgical complications, thromboembolic events, and fracture union issues in marijuana users versus non-users.

Main Methods:

• Retrospective cohort study conducted at two Level I trauma centers.
• Included adult patients (≥18 years) with tibia shaft fractures (OTA/AO 42) from 2014-2022, with at least 3 months follow-up.
• Marijuana use identified by self-report or positive urine toxicology; outcomes assessed using bivariate and multivariate analyses, controlling for confounders like tobacco use.

Main Results:

• Of 388 patients, 25% were marijuana users, who were younger, more likely male, and more frequent tobacco users.
• Marijuana users showed higher rates of 90-day surgical complications and deep infections in bivariate analysis (P < 0.05).
• Multivariate analysis revealed no significant association between marijuana use and 90-day surgical complications or deep infections (P > 0.05).

Conclusions:

• Preoperative marijuana use was not significantly associated with an increased risk of 90-day surgical complications or deep infections after tibia shaft fracture fixation.
• The study found no link between marijuana use and complications related to fracture union (thromboembolic events, nonunion, delayed union).
• Findings suggest that marijuana use, in this cohort, did not independently elevate the risk of adverse outcomes following tibia shaft fracture surgery.