Smoking delays fracture healing: study

Cigarette smoking leads to longer healing times and increased post-operative complications and infections for patients sustaining fractures or traumatic injuries to their bone, scientists, including an Indian-origin researcher, have warned.
Researchers from the University of Pennsylvania found 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).
They found that fractured bones in patients who smoke are 2.3 times more likely to result in non-healed fractures than in non-smokers.
"Cigarette smoking is widely recognised 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," said Samir Mehta, chief of the Orthopaedic Trauma and Fracture Service at Penn Medicine.

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

By analysing 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. In total, 6,480 patient cases (treated both surgically and non-surgically) were evaluated in the studies.

The study will be presented at the 2013 American Academy of Orthopaedic Surgeons annual meeting in Chicago.