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. 2019 Jul 5;8(6):255-265.
doi: 10.1302/2046-3758.86.BJR-2018-0344.R1. eCollection 2019 Jun.

Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know

J Hernigou  1 , F Schuind  2
Affiliations

Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know

J Hernigou et al. Bone Joint Res. .

Abstract

Objectives: The aim of this study was to review the impact of smoking tobacco on the musculoskeletal system, and on bone fractures in particular.

Methods: English-language publications of human and animal studies categorizing subjects into smokers and nonsmokers were sourced from MEDLINE, The Cochrane Library, and SCOPUS. This review specifically focused on the risk, surgical treatment, and prevention of fracture complications in smokers.

Results: Smokers have an increased risk of fracture and experience more complications with delayed bone healing, even if they have already stopped smoking, because some adverse effects persist for a prolonged period. Some risks can be reduced during and after surgery by local and general prevention, and smoking cessation is an important factor in lessening this risk. However, if a patient wants to stop smoking at the time of a fracture, the cessation strategies in reducing tobacco use are not easy to implement. The patient should also be warned that using e-cigarettes or other tobaccos does not appear to reduce adverse effects on health.

Conclusion: The evidence reviewed in this study shows that smoking has a negative effect in terms of the risk and treatment of fractures.Cite this article: J. Hernigou, F. Schuind. Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone Joint Res 2019;8:255-265. DOI: 10.1302/2046-3758.86.BJR-2018-0344.R1.

Keywords: Cigarettes; Fractures; Nonunion; Smoking; Tobacco.

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References

    1. Brandt A. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America. New York: Basic Books, 2007.
    1. Parascandola M. Skepticism, statistical methods, and the cigarette: a historical analysis of a methodological debate. Perspect Biol Med 2004;47:244-261. - PubMed
    1. Parascandola M, Weed DL, Dasgupta A. Two Surgeon General’s reports on smoking and cancer: a historical investigation of the practice of causal inference. Emerg Themes Epidemiol 2006;3:1. - PMC - PubMed
    1. Doll R, Hill AB. The mortality of doctors in relation to their smoking habits: a preliminary report. Br Med J 1954;1:1451-1455. - PMC - PubMed
    1. Reynolds KL, Heckel HA, Witt CE, et al. Cigarette smoking, physical fitness, and injuries in infantry soldiers. Am J Prev Med 1994;10:145-150. - PubMed