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
An evaluation of wrist and forearm range of motion during purposeful activities and exercises for distal radius fracture
An evaluation of wrist and forearm movement during purposeful activities and range of movement exercises after surgical repair of a distal radius fracture: A randomized crossover study Collis, J., Mayland, E., Wright-St Clair, V., Rashid, U., Kayes, N., & Signal, N. 2022. An evaluation of wrist and forearm movement during purposeful activities and range of…
Read More
Phantom Limb Pain, Residual Limb Pain, & Phantom Limb Sensation: Which is Which?
Written by Melissa Miller Introduction After amputation, the majority of individuals will experience phantom limb pain (PLP), residual limb pain (RLP), and/or phantom limb sensation (PLS). Experiencing these pains or sensations can greatly disrupt an individual’s quality of life. It is important to know what each of these are as each can impact the client…
Read More
Extensor Tendon Repair Protocol (zone 4-7): Immediate Controlled Active Motion (ICAM)
Howell, J.W., Merritt, W. H., & Robinson, S. J. (2005). Immediate Controlled Active Motion Following Zone 4–7 Extensor Tendon Repair. Journal of hand therapy: 18, 182-90. The Skinny- For years immobilization was the standard procedure following extensor tendon injuries in zones 4-7. As expected immobilization caused lengthy rehabilitation times, stiff joints, and tendon adhesions often…
Read More
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.