Serotonergic antidepressant use as a risk factor for nonunion after closed long bone fractures

Preoperative SSRI or SNRI use was associated with increased risk of nonunion following operative fixation of closed long bone fractures. Outcomes following open fractures were largely unaffected, likely due to the dominant biological and mechanical risks inherent to open injuries. These findings suggest the need for increased clinical vigilance in patients with closed fractures receiving serotonergic antidepressants and highlight the importance of prospective studies to further clarify causality and guide management strategies.