Cigarette smoking and open tibial fractures

Complication rates were compared in 140 smoking and 133 non-smoking patient s with open tibial fractures. Both the groups were evenly matched demograph ically 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-smok ers (P < 0.05). Bone grafting to stimulate union was required in 36 (26%) s moking patients compared with 24 (18%) non-smoking patients. In patients tr eated by intramedullary nailing exchange, nailing to achieve union was carr ied out in 24 (38%) smoking cases compared with 13 (26%) of non-smoking cas es. Smoking is associated with an increased risk of complications in patien ts with open tibial fractures. There is an increased rate of flap failure, delayed union and non-union. We recommend patients with open tibial fractur es should be advised to stop smoking to minimise these complications. (C) 2 001 Elsevier Science Ltd. All rights reserved.