Smokeless tobacco use may be linked with increased nonunion risk after scaphoid fracture
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Key takeaways:
- Smokeless tobacco use was associated with a twofold increase in nonunion risk compared with a control group.
- There was no significant difference in nonunion risk between smokeless tobacco users and smokers.
SAN FRANCISCO — Smokeless tobacco use may be associated with an increased nonunion risk in patients who undergo nonoperative management for a scaphoid fracture, according to results presented here.
“This study suggests that too few smokeless tobacco users are undergoing repair of scaphoid fractures given the higher number of nonunion experienced by this population,” Lacee K. Collins, BS, said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
To determine the effect of smokeless tobacco use on the risk of bone-related complications after nonoperative treatment of a scaphoid fracture, Collins and colleagues retrospectively reviewed data from a nationwide database. Utilizing CPT and ICD-10 codes, they created three cohorts: smokeless tobacco users, smokers and a tobacco-naïve control group.
Collins and colleagues found smokeless tobacco group was associated with a twofold higher risk for nonunion diagnosis than the tobacco-naïve control group.
In addition, Collins said there was no significant difference in nonunion diagnosis risk between smokeless tobacco users and smokers.
“We recommend that surgeons specify on their intake forms and history taking whether a patient uses any form of nicotine, not just smoking,” Collins said.
She added, “It is our opinion that smokeless tobacco users who elect to undergo nonoperative management of these fractures should consider cessation, and doing so may improve their joint retention.”
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Collins LK, et al. Paper 212. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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