Cannabis Users Face More Surgical Complications After Hand Fracture Repair Than Non-Users
Among 80,787 patients who underwent metacarpal fracture fixation, cannabis users had higher rates of multiple medical and surgical complications compared to non-users, though fewer complications than tobacco users.
Quick Facts
What This Study Found
Compared to controls, cannabis users (6.7% of cohort) had higher rates of acute kidney injury, cardiac arrest, DVT, hypoglycemia, MI, pneumonia, sepsis, stroke, UTI, surgical site infection, and fracture malunion after metacarpal fracture fixation. However, compared to tobacco users, cannabis users had fewer complications including lower rates of pneumonia, UTI, and surgical revision.
Key Numbers
80,787 patients; 5,043 (6.7%) with cannabis use disorder; higher rates of 9 medical complications and 2 surgical complications vs. controls; fewer complications than tobacco users for several outcomes.
How They Did This
Retrospective analysis of 80,787 patients from a US insurance claims database (2010-2022) who underwent metacarpal fracture fixation. 5,043 had diagnosed cannabis use disorder. Propensity matched for age, sex, and Charlson Comorbidity Index.
Why This Research Matters
As surgeons increasingly encounter patients who use cannabis, understanding perioperative risk profiles becomes essential. This large study provides specific complication data that can inform preoperative counseling and perioperative management.
The Bigger Picture
Cannabis users may occupy a middle ground for surgical risk: worse than non-users but better than tobacco users. This nuance matters for clinical decision-making and patient counseling.
What This Study Doesn't Tell Us
Claims database cannot determine causation. Cannabis use identified by diagnosis codes likely underestimates prevalence and overrepresents heavy users. Cannot control for all confounders. Propensity matching for only three variables.
Questions This Raises
- ?What specific mechanisms drive the increased surgical complication risk in cannabis users?
- ?Should perioperative protocols be modified for cannabis users undergoing orthopedic surgery?
Trust & Context
- Key Stat:
- 6.7% of hand fracture patients had cannabis use disorder
- Evidence Grade:
- Large propensity-matched claims database study, limited by diagnosis code identification of cannabis use and inability to establish causation.
- Study Age:
- 2025 publication with 2010-2022 data
- Original Title:
- Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture.
- Published In:
- The journal of hand surgery Asian-Pacific volume, 30(5), 506-513 (2025)
- Authors:
- Kishan, Arman, Bergstein, Victoria E(2), Kishan, Ansh, Jankowski, Pawel, Tuffaha, Sami H, Laporte, Dawn M
- Database ID:
- RTHC-06838
Evidence Hierarchy
Frequently Asked Questions
Does cannabis use affect surgery outcomes?
In this study of 80,787 hand fracture surgeries, cannabis users had higher rates of multiple complications including infections, cardiac events, and fracture malunion compared to non-users. However, their complication rates were lower than tobacco users for several outcomes.
Should I stop using cannabis before surgery?
This study found cannabis users had higher surgical complication rates. While it cannot prove cannabis caused the complications, the association is worth discussing with a surgeon before any procedure.
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Cite This Study
https://rethinkthc.com/research/RTHC-06838APA
Kishan, Arman; Bergstein, Victoria E; Kishan, Ansh; Jankowski, Pawel; Tuffaha, Sami H; Laporte, Dawn M. (2025). Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture.. The journal of hand surgery Asian-Pacific volume, 30(5), 506-513. https://doi.org/10.1142/S2424835525500456
MLA
Kishan, Arman, et al. "Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture.." The journal of hand surgery Asian-Pacific volume, 2025. https://doi.org/10.1142/S2424835525500456
RethinkTHC
RethinkTHC Research Database. "Weeding Out the Problem: Associations of Cannabis and Tobacc..." RTHC-06838. Retrieved from https://rethinkthc.com/research/kishan-2025-weeding-out-the-problem
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.