Non-tobacco nicotine dependence is associated with increased complications following clavicle open reduction internal fixation
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By
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Akin A. Adio
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Rahul K. Goyal
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Abby Skiena
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Mohammad Daher
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John G. Horneff
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Hafiz F. Kassam
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Brian W. Hill
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Joseph A. Abboud
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June 18, 2026
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Clinical Scorecard: Dependence on Non-Tobacco Nicotine Linked to Higher Complication Rates After Clavicle Open Reduction Internal Fixation
At a Glance
| Category | Detail |
|---|
| Condition | Clavicle fractures |
| Key Mechanisms | Non-tobacco nicotine dependence may impede wound healing and fracture union, increasing complication rates. |
| Target Population | Adolescents and young adults with clavicle fractures. |
| Care Setting | Orthopedic surgical settings. |
Key Highlights
- Clavicle fractures account for 2.6-5% of all adult fractures.
- Surgical fixation rates for clavicle fractures have increased by 445% from 2000 to 2022.
- Non-tobacco nicotine dependence is on the rise among adolescents and young adults.
- Tobacco use is known to increase fracture nonunion rates and infection risk.
- The study investigates postoperative complications related to non-tobacco nicotine dependence.
Guideline-Based Recommendations
Diagnosis
- Use ICD-10 codes to identify patients with clavicle fractures.
Management
- Consider non-tobacco nicotine dependence as a risk factor for complications post-ORIF.
Monitoring & Follow-up
- Evaluate for postoperative complications within 90 days, including infection and nonunion.
Risks
- Non-tobacco nicotine dependence may lead to higher complication rates after surgical fixation.
Patient & Prescribing Data
Patients undergoing ORIF of clavicle fractures.
Patients with non-tobacco nicotine dependence may require closer monitoring for complications.
Clinical Best Practices
- Assess nicotine dependence status preoperatively.
- Utilize propensity score matching to balance cohorts in studies.
- Monitor for surgical site infections and nonunion in patients with nicotine dependence.
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