To evaluate the effect of smoking on the union time of the long bone shaft fractures.

We retrospectively analysed eighty-four patients with a long bone shaft fracture who were treated during the last four years. Patients with polytrauma, severe comminuted fracture, open fracture over grade III, ESRD or other internal diseases were excluded. In this study we separated the groups into smoking and non-smoking groups. Also we observed whether there was any significant difference in the union time and other factors such as the age, sex, fracture location and configuration, and method of fixation by using medical records and radiographs.

A significant difference in union time was found between the smoking group and the non-smoking group (p=0.041), especially in the tibia. The average union time was 12.54±1.62 weeks in the smoking group and 11.53±2.59 weeks in non-smoking group. There were three non-union cases in the smoking group and one in the non-smoking group. Other factors appeared to have no significant influences. The negative effect of smoking was more obvious in patients in their 5th and 6th decades with a distal tibia shaft fractures.

It seems highly beneficial that patients be recommend to quit smoking while being treated for a fracture, because smoking prolongs the healing time.