The Association Between Diagnosed Cannabis Use Disorder and Post-Operative Outcomes in Lower Extremity Trauma Patients: A Retrospective Database Review.

Background: Patients undergoing surgical management for lower extremity long bone fractures may present with associated Cannabis Use Disorder (CUD), which could impact non-union rates and emergency department (ED) utilization. Materials and Methods: A retrospective review of patient records from January 2010 to April 2022 was conducted using a claims database. Patients who underwent open and closed treatments for lower extremity long bone shaft fractures were included. CUD status was compared within the eligible population, and statistical analysis included evaluation of non-union rates at 16 weeks and 9 months, as well as 30-day ED visits and readmissions. Demographic characteristics were also assessed, including age, gender, Elixhauser Comorbidity Index (ECI) score, and insurance coverage. Results: Patients with CUD were younger (34.47 vs. 37.78 years) and more likely to be male (64.96% vs. 47.24%) with higher comorbidity scores (ECI 4.55 vs. 3.51). They exhibited higher odds of non-union at 16 weeks (OR 2.63 [1.96, 2.85]) and 9 months (OR 2.12 [1.78, 2.54]). CUD was also an independent predictor of increased post-operative ED utilization, including visits (OR 5.82 [4.45, 7.61]) and readmissions (OR 1.61 [1.42, 1.84]), compared to patients without CUD (p-value <0.05). Conclusions: Cannabis Use Disorder among orthopaedic trauma patients may correlate with elevated risks of non-union and ED utilization following surgical management of lower extremity long bone fractures.