{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:11:24Z","timestamp":1793171484546,"version":"4.5.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"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":["Foot Ankle Int."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tobacco use is known to have adverse outcomes in ankle open reduction and internal fixation (ORIF). Non-tobacco nicotine dependence (NTND), driven by the rising popularity of e-cigarettes and alternative nicotine products, is increasingly prevalent, but its relationship with ankle ORIF is unknown. This study evaluated the association of NTND on perioperative and long-term outcomes following ankle ORIF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was conducted using a large database to identify patients \u226518\u2009years who underwent bimalleolar and trimalleolar ankle ORIF from 2004 to 2023. Patients were stratified into NTND, tobacco use, and non-nicotine control cohorts based on\n                      <jats:italic toggle=\"yes\">International Classification of Disease, Tenth Revision<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">ICD-10<\/jats:italic>\n                      ) coding. Propensity score matching (1:1) was performed to balance demographics and comorbidities. Outcomes were assessed at 90 days and 2 years. Odds ratios with 95% CIs and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      values were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>63\u2009853 patients were eligible for analysis. A total of 4716\u2009NTND patients were matched with 50\u2009903 controls and 8234 tobacco users. NTND patients had higher odds of complications within 90\u2009days, including stroke (OR 2.25, 95% CI 1.46-3.47), pneumonia (OR 1.81, 95% CI 1.27-2.58), surgical site infection (OR 1.82, 95% CI 1.37-2.41), wound dehiscence (OR 1.53, 95% CI 1.18-2.00), emergency department utilization (OR 1.68, 95% CI 1.47-1.92), and hospitalizations (OR 1.42, 95% CI 1.20-1.68). At 2 years, NTND patients showed higher rates of non\u2011union or mal\u2011union (OR 3.04, 95% CI 2.34-3.87), non\u2011union repair (OR 1.33, 95% CI 1.08-1.74), and hardware removal (OR 1.19, 95% CI 1.06-1.34) versus controls. Compared with tobacco users, NTND patients had increased odds of non\u2011union or mal\u2011union (OR 2.46, 95% CI 1.97-3.08) and hardware removal (OR 1.21, 95% CI 1.07-1.35).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>NTND is associated with significantly increased short-term and long-term complications following ankle ORIF. These findings suggest NTND is not a benign alternative and may confer risks comparable to or greater than tobacco use, warranting further prospective investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007251390529","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T04:48:11Z","timestamp":1764218891000},"page":"143-152","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Non-Tobacco Nicotine Dependence Is Associated With Increased Risk of Reoperation and Complications After Ankle Fracture ORIF: A Propensity-Matched Database Study"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2006-3976","authenticated-orcid":false,"given":"Samuel A.","family":"Florentino","sequence":"first","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander S.","family":"Rascoe","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander N.","family":"Berk","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan M.","family":"Good","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Adelstein","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Wetzel","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Ochenjele","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua K.","family":"Napora","sequence":"additional","affiliation":[{"name":"University Hospitals, Cleveland Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00041.2011"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00789"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-021-02927-z"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001293"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-23-01053"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.31729\/jnma.5532"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00343"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2018.05.006"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715620455"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.62544"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.23.00745"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04291-9"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620x.82b3.10064"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2024.02.003"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/08958378.2024.2319315"},{"key":"e_1_3_3_17_2","first-page":"1","article-title":"Current electronic cigarette use among adults aged 18 and over: United States, 2021","volume":"475","author":"Kramarow EA","year":"2023","unstructured":"Kramarow EA, Elgaddal N. 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