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Bone Joint Res. 2013 Jun 14;2(6):102-11. doi: 10.1302/2046-3758.26.2000142. Print 2013.

The effect of smoking on bone healing: A systematic review.

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1
King's College London Dental Institute, Departmentof Periodontology, Guy's Hospital Campus, LondonSE1 9RT, UK.

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.

KEYWORDS:

Bone healing; Bone repair; Fracture healing; Smoking; Systematic review

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