Smoking as a predictor of negative outcome in diaphyseal fracture healing
Open accessAbstract
Purpose The purpose of this study was to evaluate the impact of tobacco abuse in the consolidation of fractures.Methods We retrospectively identified all patients with a diaphyseal fracture (femur, tibia, or humerus), between January 1999 and December 2010, in our orthopaedic trauma registry (Erasme hospital, Brussels, Belgium). Thirty-eight diaphyseal nonunions (ten femurs, 16 tibias and 12 humerus) were identified. Each nonunion was paired (on age, sex and location) with two control-healed fractures (76 control patients). The chi-squared test and a binary logistic regression were used for statistical analysis.Results In multivariate analysis, smoking (tobacco use) was significantly associated with nonunion, whether the fracture was open or closed (p < 0.01). In univariate analysis, open fracture was associated with a higher risk of nonunion (p < 0.05), while external fixation was associated with better bone healing (p < 0.05).Conclusion Tobacco is confirmed as a deleterious factor for diaphyseal bone healing.
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Smokers have a higher risk of developing a nonunion after a diaphyseal fracture of the humerus, femur, or tibia, in both open and closed forms.
“In this regard, Hernigou and Schuind showed that smokers have a higher risk of developing a nonunion after a diaphyseal fracture of the humerus, femur, or tibia, in both open and closed forms [54].”
From Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic (2021) · cites this paper as [54]
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- Authors
- Hernigou, J., & Schuind, F.
- Affiliations
- Erasmus Hospital (BE)
- Corresponding author
- Hernigou, Jacques
- Venue
- International Orthopaedics
- Published
- 2013-02-08
- Volume
- 37
- Issue
- 5
- Pages
- 883-887
- ISSN
- 0341-2695 (ISSN-L)
- 1432-5195
- PMC
- PMC3631490
- OpenAlex
- W2039384081
- Cited by
- 117
- References
- 19
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 9 · 2023: 6 · 2022: 10 · 2021: 12 · 2020: 11 · 2019: 6 · 2018: 9 · 2017: 11 · 2016: 11 · 2015: 7 · 2014: 2 · 2013: 6
- FWCI
- 6.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Orthopaedics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
- Keywords
- smoking, tobacco use, diaphyseal fractures, nonunion, bone regeneration, femoral fracture, tibial fractures, humerus fracture, open fractures, external fixation, risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Femoral Fractures, Fractures, Ununited, Humans, Humeral Fractures, Male, Middle Aged, Retrospective Studies, Risk Factors, Smoking, Tibial Fractures, Fracture Healing, Diaphyses, Fractures, Bone, Young Adult
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