Smoking as a predictor of negative outcome in diaphyseal fracture healing

Purpose The purpose of this study was to evaluate the impact of tobacco abuse in the consolidation of fractures. Methods We retrospectively identified all patients with a diaphyseal fracture (femur, tibia, or humerus), between January 1999 and December 2010, in our orthopaedic trauma registry (Erasme hospital, Brussels, Belgium). Thirty-eight diaphyseal nonunions (ten femurs, 16 tibias and 12 humerus) were identified. Each nonunion was paired (on age, sex and location) with two control-healed fractures (76 control patients). The chi-squared test and a binary logistic regression were used for statistical analysis. Results In multivariate analysis, smoking (tobacco use) was significantly associated with nonunion, whether the fracture was open or closed ( p