{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:16Z","timestamp":1785218416588,"version":"3.55.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distal radius fractures (DRFs) are among the most common fragility-related fractures in older adults. Although open reduction and internal fixation (ORIF) is often selected to restore function and enable early mobilization, preoperative risk factors such as tobacco use may impair bone metabolism and immune function, affecting ORIF outcomes. This study aimed to investigate 90-day and 2-year outcomes after DRF ORIF in geriatric patients with a history of tobacco use or nicotine dependence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort analysis was performed using a nationwide database to identify patients aged \u226560 years who underwent DRF ORIF with at least two-year postoperative follow-up between 2005-2025. Patients were categorized into tobacco users and controls. Propensity score matching (1:1) was applied for demographics and major comorbidities. Primary outcomes included implant removal, malunion\/nonunion repair, and infection at two years postoperatively; secondary outcomes encompassed ninety-day medical systemic complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, 5,725 patients remained in each cohort. Tobacco users had higher rates of sepsis (0.2% vs 0%, p=0.002), renal failure (RR 2.64, p=0.001), pneumonia (RR 2.64, p&lt;0.0001), wound complications (RR 1.62, p=0.004), and postoperative infection (RR 2.46, p&lt;0.0001). At two years, rates of malunion\/nonunion repair (RR 2.08, p=0.001) and malunion (RR 1.54, p=0.042) remained significantly elevated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A history of tobacco use is associated with increased 90-day and 2-year complications after ORIF for DRF in older adults. These findings highlight the importance of preoperative counselling, smoking cessation, and perioperative optimization to improve surgical outcomes in this population. Further research is needed to identify targeted interventions and strategies to reduce these complications and improve recovery in older adults with a history of tobacco use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261467961","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:47:05Z","timestamp":1783666025000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tobacco use and complications after open reduction and internal fixation of distal radius fractures in older adults: A propensity score-matched analysis"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4410-2290","authenticated-orcid":false,"given":"Zina","family":"Smadi","sequence":"first","affiliation":[{"name":"University of Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5822-7528","authenticated-orcid":false,"given":"Bilal","family":"Irfan","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"McBee","sequence":"additional","affiliation":[{"name":"The University of Texas Health Science Center at San Antonio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2740-4438","authenticated-orcid":false,"given":"Barock","family":"Tesfaye","sequence":"additional","affiliation":[{"name":"Vanderbilt University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Phan","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Mubarak","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Boutros","sequence":"additional","affiliation":[{"name":"Saint Joseph University of Beirut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Washington University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2023.11.065"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2023.05.033"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13216475"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/21514593211004528"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.18715"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2151458514542337"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31829c739a"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2016.07.014"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.86.BJR-2018-0344.R1"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2024.04.003"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2024.02.003"},{"key":"e_1_3_3_13_2","first-page":"4691","article-title":"Smoking-related complications in foot and ankle surgery: a systematic review","volume":"28","author":"Pour JS","year":"2024","unstructured":"Pour JS, Garibaldi R, Seidel A, et al. Smoking-related complications in foot and ankle surgery: a systematic review. 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