Smoking Prolongs Fracture Healing

Smoking Prolongs Fracture Healing

Smokers already get quite a bit of lecturing when it comes to the effects of smoking and the use of tobacco products on their health. Smoking has been linked to cancer, cardiovascular diseases, and several other preventable health conditions. The habit is also frowned upon in public due to secondary exposure concerns.

Researcher from the University of Pennsylvania’s Perelman School of Medicine have another concern to share with smokers, as it’s been found to prolong fracture healing and can increase the likelihood of infection in post-operative patients.

A new study from the Department of Orthopaedic Surgery at the Perelman School of Medicine at the University of Pennsylvania substantiates early evidence that cigarette smoking can lead to longer healing times, an increased rate of post-operative complication, and potential infection for patients who have sustained fractures or traumatic injuries to their bones.

The results were assess from analyzing several computerized medical literature databases including Medline, EMBASE and Cochrane.

The researchers collated previous studies which examined the effects of smoking on bone and soft tissue healing. A total of 6,480 patient cases with fractures of the tibia, femur or hip, ankle, humerus, and multiple long bones (surgically and non-surgically treated) were evaluated.

Samir Mehta, MD, chief of the Orthopaedic Trauma and Fracture Service at Penn Medicine, expressed the significant risk fracture patients are taking when continuing to smoke, especially during the initial recovery phase.

Approximately 6.8 million fractures require medical treatment in the US annually. It’s recommended patients take the healing time as an opportunity to consider quitting.

Fractured bones in patients who smoke took roughly six weeks longer to heal than fractured bones in a non-smoker (30.2 weeks compared to 24.1 weeks). Recovering patients who smoke were 2.3 times more likely to result in non-healed fractures.

The act of smoking a cigarette causes the blood vessels of the body, blood vessels circulating vital nutrients and oxygen essential for the process of healing, to narrow. Nicotine, the chief addictive chemical in cigarettes, can increase both blood pressure and heart rate, and decreases proper blood flow to the heart and other parts of the body by narrowing the overall vasculature.

An increased amount of carbon monoxide is introduced into the blood during smoking, lessening the amount of oxygen that can be carried in the bloodstream. There is a finite amount of circulatory room in the vessels, veins, and arteries.

Often the supply of blood to a broken limb can be limited, thus smoking further inhibits the already restricted blood flow. Without adequate blood flood the cellular musculature of the injury site can begin to die off (necrosis) or easily become infected.

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

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