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The effects of smoking on fractures and ligament injuries

Cigarette smoking, which causes over 8.6 million illnesses annually in the U.S., has been shown to have harmful effects on a variety of orthopedic conditions. Studies have shown that the numerous toxins contained in cigarette smoke can undermine fracture and ligament repair following injury. In addition, smokers have higher rates of hip fracture, fracture healing problems and bone infections and smoking has been shown to impair soft tissue wound healing. Two new studies, funded by the National Institutes of Health and the National Football League Charities, examined the effects of smoking on fractures and ligament healing in mice and found that healing of both types of injury was delayed. The studies are published in the December 2006 issue of the Journal of Orthopaedic Research (http://www.interscience.wiley.com/journal/jor), the official journal of the Orthopaedic Research Society.

Led by Hossam B. El-Zawawy of the Washington University School of Medicine in St. Louis, MO the first study involved 35 mice divided into a smoking group, which was exposed to cigarette smoke 6 days per week for a month, and a control group. Surgery was performed on all the mice to achieve a simple fracture. Researchers used type II collagen expression as a marker of cartilage formation (chondrogenesis) during healing. They found that smoking delayed fracture healing and that it began at the early stages of the healing process, although over time it did not inhibit normal healing. Specifically, they were able to show that there was a delay in the development of mature cartilage cells in the mice exposed to cigarette smoke. This was the first study to analyze the molecular and cellular mechanisms of fracture healing in mice exposed to smoke.

The authors note that while the study shows a clear relationship between smoking and cartilage formation, smoking probably has other effects on fracture healing, which shoul
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Source:John Wiley & Sons, Inc.


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