Marijuana Use Did Not Increase Complication Risk After Tibia Fracture Surgery | Research

The takeaway

Among 388 patients who underwent tibia shaft fracture fixation, preoperative marijuana use was not associated with increased risk of surgical complications, blood clots, infections, or fracture healing problems.

Orthopedic surgeons, trauma surgeons, and cannabis users facing fracture surgery.

No increased complication risk in 96 marijuana-using fracture patients

What the researchers found

Among 388 patients (25% marijuana users), marijuana use was not associated with 90-day surgical complications (OR 2.01, 95% CI 0.83-4.84), deep infection (OR 2.97, 95% CI 0.95-9.25), thromboembolic events, or fracture union complications on multivariate analysis controlling for tobacco use, open fracture, and ASA class.

Why it matters

Marijuana use is common among trauma patients (25% in this study). Surgeons need evidence-based guidance on whether preoperative cannabis use affects surgical outcomes. This study suggests it does not increase complication risk for this common fracture type.

The numbers in context

N = 388 patients. Mean age 37.6. 66.5% male. 96 (25%) marijuana users. Marijuana users younger (30.5 vs 40 years, p significant). No significant associations with surgical complications, deep infection, thromboembolic events, or fracture union problems.

How the study worked

Retrospective cohort study at two Level I academic trauma centers from 2014-2022. Patients with tibia shaft fractures and minimum 3-month follow-up. Marijuana use identified by self-report or positive urine toxicology. Multivariate regression controlled for tobacco use, open fracture, and ASA class.

What this study cannot tell us

Retrospective design with potential for unmeasured confounders. Cannabis use was binary (yes/no) without dose or frequency data. Some individual complication odds ratios were elevated but not statistically significant, possibly due to limited power. Results specific to tibia shaft fractures.

How to read the evidence

Retrospective cohort from two Level I trauma centers. Moderate evidence limited by sample size and binary exposure measure.

When this study was published

Published in 2025 with data from 2014-2022.

The bigger picture

As more jurisdictions legalize cannabis, trauma surgeons will increasingly encounter patients who use marijuana preoperatively. Evidence that cannabis does not independently increase fracture surgery complication risk can help inform surgical decision-making.

Questions still open

Would results differ for heavy daily users? Do these findings extend to other fracture types and surgical procedures?

Common questions

Should I stop using cannabis before surgery?

This study found no increased complication risk for tibia fracture surgery, but individual circumstances vary. Discuss cannabis use with your surgical team as it may be relevant for anesthesia management.

Why were cannabis users younger?

Marijuana users in this study had a mean age of 30.5 vs 40 for non-users, reflecting the higher prevalence of cannabis use among younger adults generally.

Read the original research

Marijuana Use and Complication Risk After Tibia Shaft Fracture Fixation.

Journal of orthopaedic trauma, 39(3), 137-143

View on PubMed ↗Publisher’s paper ↗

Citation

Maxson, Ridge; Rapaport, Sarah; Covarrubias, Oscar; Ghanem, Diane; Moreno-Diaz, Andres F; Ross, Ryan; Bergstein, Victoria E; O'Sullivan, Lucy; Rogers, Davis; Mitchell, Phillip M; Shafiq, Babar. (2025). Marijuana Use and Complication Risk After Tibia Shaft Fracture Fixation.. Journal of orthopaedic trauma, 39(3), 137-143. https://doi.org/10.1097/BOT.0000000000002945