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. 2013 Jun 14;2(6):102-11.
doi: 10.1302/2046-3758.26.2000142. Print 2013.

The effect of smoking on bone healing: A systematic review

Affiliations

The effect of smoking on bone healing: A systematic review

R A Patel et al. Bone Joint Res. .

Abstract

Objectives: To review the systemic impact of smoking on bone healing as evidenced within the orthopaedic literature.

Methods: A protocol was established and studies were sourced from five electronic databases. Screening, data abstraction and quality assessment was conducted by two review authors. Prospective and retrospective clinical studies were included. The primary outcome measures were based on clinical and/or radiological indicators of bone healing. This review specifically focused on non-spinal orthopaedic studies.

Results: Nine tibia studies and eight other orthopaedic studies were considered for systematic review. Of these 17 studies, 13 concluded that smoking negatively influenced bone healing.

Conclusions: Smoking has a negative effect on bone healing, in terms of delayed union, nonunion and more complications.

Keywords: Bone healing; Bone repair; Fracture healing; Smoking; Systematic review.

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Conflict of interest statement

ICMJE Conflict of Interest:None declared

Figures

Fig. 1
Fig. 1
Flow diagram for the systematic review.

References

    1. Al-Hadithy N, Sewell MD, Bhavikatti M, Gikas PD. The effect of smoking on fracture healing and on various orthopaedic procedures. Acta Orthop Belg 2012;78:285–290 - PubMed
    1. Gaston MS, Simpson AH. Inhibition of fracture healing. J Bone Joint Surg [Br] 2007;89-B:1553–1560 - PubMed
    1. Kwiatkowski TC, Hanley EN Jr, Ramp WK. Cigarette smoking and its orthopedic consequences. Am J Orthop (Belle Mead NJ) 1996;25:590–597 - PubMed
    1. Sloan A, Hussain I, Maqsood M, Eremin O, El-Sheemy M. The effects of smoking on fracture healing. Surgeon 2010;8:111–116 - PubMed
    1. Giannoudis PV, Einhorn TA, Marsh D. Fracture healing: the diamond concept. Injury 2007;38(Suppl 4):S3–S6 - PubMed