Speakers - 2026

Title: Neck of Femur Fracture in a Young Adult with Chronic Cannabis Use: A Case Report and Review of Potential Associations

Abstract

Neck of femur (NOF) fractures in young adults are uncommon and typically associated with high-energy trauma or underlying metabolic bone disease(1). Cannabis use has been increasingly studied for its potential effects on bone metabolism, with emerging evidence suggesting possible associations with reduced bone mineral density and increased fracture risk(2). A 36-year-old male presented with severe lower back and left leg pain following a slip and fall onto his buttocks. His medical history included myasthenia gravis treated with pyridostigmine and a benign melanocytic naevus. He was prescribed medical cannabis and worked in a medical cannabis facility. Pelvic and left hip radiographs demonstrated a left subcapital NOF. He was admitted under trauma and orthopaedics and underwent surgical fixation with a left two-hole dynamic hip screw on. Bone biochemistry was within normal limits, with no evidence of metabolic abnormality. Low-energy neck of femur fractures in young adults are unusual and should prompt evaluation for contributing risk factors. Cannabis has been implicated in altered bone remodelling through cannabinoid receptor activity, potentially affecting bone density and strength(2,3). In this case, medical cannabis use alongside tobacco and alcohol consumption may represent modifiable risk factors contributing to fracture susceptibility, although causation cannot be established. This case highlights a neck of femur fracture in a young adult following low-energy trauma in the context of medical cannabis use. Further research is required to better understand the potential relationship between cannabis exposure and bone health.

What will the audience take away from presentation?

1. Increased clinical awareness and risk assessment
This presentation will help clinicians recognise that neck of femur fractures can occur in younger patients following low-energy mechanisms, particularly in the presence of modifiable risk factors such as cannabis, tobacco, and alcohol use. This will encourage more comprehensive social histories and earlier consideration of bone health assessment in atypical presentations.

2. Informing clinical decision-making and patient counselling
The findings will support healthcare professionals in counselling patients regarding potential lifestyle-related risk factors affecting bone health and fracture risk. This may contribute to improved preventative strategies, including substance use reduction, bone health screening, and targeted interventions in at-risk populations.

3. Supporting future research, education, and guideline development
This case contributes to the growing body of evidence on cannabis and bone health and may be used by clinicians, educators, and researchers to inform teaching, stimulate further research, and support development of clinical guidelines. It highlights an emerging clinical consideration that may influence future screening practices, research design, and multidisciplinary education.