Smoking prolongs fracture healing

A new study led by an Indian researcher from the Department of Orthopaedic Surgery at the Perelman School of Medicine at the University of Pennsylvania corroborates early evidence showing that cigarette smoking leads to longer healing times and an increased rate of post-operative complication and infection for patients sustaining fractures or traumatic injuries to their bone.

“Cigarette smoking is widely recognized as one of the major causes of preventable disease in the US, but there has been a lack of evidence showing other side effects of smoking, such as how it changes the way our bones heal,” Samir Mehta, MD, chief of the Orthopaedic Trauma and Fracture Service at Penn Medicine said.

“Our study adds substantial support to a growing body of evidence showing that smoking presents a significant risk to fracture patients. These risks need to be addressed with the patient both at the time of injury and when considering surgical treatment,” he said.

Results of the study show that for all injury types, fractured bones in patients who smoke take roughly six weeks longer to heal than fractured bones in a non-smoker (30.2 weeks compared to 24.1 weeks).

Additional results show that fractured bones in patients who smoke are 2.3 times more likely to result in non-unions (non-healed fractures) than in non-smokers.

Using Medline, EMBASE and Cochrane computerized literature databases, the researchers collated previous studies that have examined the effects of smoking on bone and soft tissue healing.

By analyzing these studies, the team sought to find an association between smoking and healing time, and various complications such as post-surgical infection.

Studies included in the analysis focused on fractures of the tibia, femur or hip, ankle, humerus, and multiple long bones.