The effect of smoking on fracture healing and on various orthopaedic procedures

Published online: Jun 27 2012

Nawfal AL-HADITHY, Mathew D. SEWELL, Mainudden BHAVIKATTI, Panagiotis D. GIKAS

From Lister General Hospital, Stevenage and Royal National Orthopaedic Hospital, Stanmore, UK


Ten percent of all fractures lead to problems with healing. Smoking is said to be a cause. There are 13.5 million smokers in the UK. Healing of tibial fractures, for instance, requires two more months in smokers. Nicotine, carbon monoxide and hydrogen cyanide are most often seen as the offenders, among the 4000 chemicals found in cigarettes. Many studies plead for the negative effect of smoking in general, yet there is uncertainty as to the precise role of nicotine. The authors recommend that patients should attempt smoking cessation therapy before elective orthopaedic treatment.