Systematic review and meta-analysis of 19 cohort studies (6,374 fractures) examining the association between cigarette smoking and complications — specifically nonunion, healing time, and wound infection — following operative treatment of long-bone fractures.
When a smoker presents with a long-bone fracture — especially an open or tibial fracture — counsel them that their nonunion risk is more than doubled and initiate smoking cessation intervention: a cited RCT found that a perioperative cessation intervention reduced postoperative complication rates from 52% to 18% in orthopedic patients, and a separate RCT showed smokers were 2.51 times more likely to have a postoperative complication versus those in a cessation intervention group.
Systematic review and meta-analysis of 19 cohort studies (6,374 fractures) examining the association between cigarette smoking and complications — specifically nonunion, healing time, and wound infection — following operative treatment of long-bone fractures.
When a smoker presents with a long-bone fracture — especially an open or tibial fracture — counsel them that their nonunion risk is more than doubled and initiate smoking cessation intervention: a cited RCT found that a perioperative cessation intervention reduced postoperative complication rates from 52% to 18% in orthopedic patients, and a separate RCT showed smokers were 2.51 times more likely to have a postoperative complication versus those in a cessation intervention group.