Houston Methodist. Leading Medicine

Knee News

Smokers Heal Slower after a Broken Lower Leg

Many studies have shown that smoking is bad for your health. Lung cancer, heart disease, poor circulation, and delayed skin healing are only a few of the effects of tobacco. Other studies have looked at the effect of tobacco use on bone healing. Broken bones or fractures that poke through the skin are called open or compound fractures. Resesarchers have studied open fractures of the main lower leg bone (the tibia). Doctors wanted to know the effect of smoking on healing of open tibia fractures. They also wanted to see if using one kind of operation to repair the break was better than another.

Open tibial fractures must be closed and held together until healing has occurred. This means an operation using either pins through the bone or a long pin down the inside of the bone, called a nail.

Even with proper care, these fractures often develop problems. The problems include infection, failure to heal, or inability to heal correctly. Smoking can create even more problems for the patient. Tobacco (even just one cigarette) can slow the blood flow to the healing area. Toxins from tobacco stay in the body at least one week. These toxins and the lack of oxygen delay wound and fracture healing.

Smokers with open tibial fractures heal slower than nonsmokers. This is true no matter what kind of implant is used to hold the bone together. In terms of bone healing, it's not yet clear whether light use of tobacco is different from heavy use of tobacco. Future studies are needed to determine this.


E. J. Harvey, MD, et al. Deleterious Effect of Smoking on Healing of Open Tibia-Shaft Fractures. In The American Journal of Orthopedics. September 2002. Vol. 30. No. 9. Pp. 518-521.

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*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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