The effect of smoking on bone healing

Abstract

Objectives To review the systemic impact of smoking on bone healing as evidenced within the orthopaedic literature. Methods A protocol was established and studies were sourced from five electronic databases. Screening, data abstraction and quality assessment was conducted by two review authors. Prospective and retrospective clinical studies were included. The primary outcome measures were based on clinical and/or radiological indicators of bone healing. This review specifically focused on non-spinal orthopaedic studies. Results Nine tibia studies and eight other orthopaedic studies were considered for systematic review. Of these 17 studies, 13 concluded that smoking negatively influenced bone healing. Conclusions Smoking has a negative effect on bone healing, in terms of delayed union, nonunion and more complications. Article focus  To review the systemic impact of smoking on bone healing as evidenced within the non-spinal orthopaedic literature Key messages  Smoking has a negative impact on bone healing Strengths and limitations  This study sets out to review bone healing in a systematic manner  A meta-analysis could not be performed due to differences in study designs, meth-ods of measuring bone healing and pre-sentation of data between studies