Cigarette smoking and open tibial fractures.
Complication rates were compared in 140 smoking and 133 non-smoking patients with open tibial fractures. Both the groups were evenly matched demographically and in terms of primary fracture treatment. Flap failure complicated 7 (20%) patients in the smoking group and 4 (14%) in the non-smoking group. The mean time to union was 32 weeks for smokers and 28 weeks for non-smokers (P<0.05). Bone grafting to stimulate union was required in 36 (26%) smoking patients compared with 24 (18%) non-smoking patients. In patients treated by intramedullary nailing exchange, nailing to achieve union was carried out in 24 (38%) smoking cases compared with 13 (26%) of non-smoking cases. Smoking is associated with an increased risk of complications in patients with open tibial fractures. There is an increased rate of flap failure, delayed union and non-union. We recommend patients with open tibial fractures should be advised to stop smoking to minimise these complications.
Adams
C I
CI
Orthopaedic Trauma Unit, Edinburgh Royal Infirmary, Lauriston Place, Scotland EH3 9YW, Edinburgh, UK.
Keating
J F
JF
Court-Brown
C M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D005597:Fractures, Open / Q000150:complications* / Q000601:surgery; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D013524:Surgical Flaps / Q000592:standards; D013978:Tibial Fractures / Q000150:complications* / Q000601:surgery; D017211:Treatment Failure; D014946:Wound Infection / Q000209:etiology