Effects of methamphetamines in patients with tibial shaft fractures: a retrospective cohort study at a Level 1 trauma center.

Objective: To compare perioperative complications of patients with tibial shaft fractures treated with intramedullary implants in methamphetamine abusers and abstainers. Design: Retrospective data analysis. Setting: Level 1 academic trauma facility, 2014‒2019. Patients/Participants: One hundred forty-eight patients who underwent intramedullary nail fixation for tibial shaft fractures, 22 (14.9%) of whom abused methamphetamines. Intervention: Tibial intramedullary nail. Main Outcome Measurements: Postoperative complications include infection, nonunion, malunion, reoperation. Results: In orthopaedic trauma patients with tibial shaft fractures, methamphetamine use was associated with higher rates of infection (P = 0.01), nonunion (P = 0.037), and increased number of reoperations (P = 0.035). Conclusion: Methamphetamine use is associated with risk of postoperative infection, nonunion, and multiple reoperations in orthopaedic trauma patients with tibial shaft fractures. Level of Evidence: Level III.