Marijuana Use Did Not Increase Complication Risk After Tibia Fracture Surgery

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.

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.

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.

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.

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.