are more at risk of injury is unclear, although general weakness, inferior balance and poorer neuromuscular function have been identified as possible reasons (Kyro 1993; Nelson 1994; Sacks and Nelson, 1994). et al., et al., The adverse effects of smoking on fracture healing were reported in patients that underwent spinal fusion (spondylosyndesis or arthrodesis), with smokers generally having a higher rate of pseudoarthritis than the non-smoking control groups (40% vs. 8%) (Sloan 2010). Several clinical studies have been et al., carried out on human subjects regarding fracture healing and smoking (Whitesides 1994; Silcox 1995). Carpenter (1996), reported that outcomes et al., et al., et al. of lumbar fusion operations were significantly more favourable for non-smokers (P<0.02). The group also found that non-smokers were more likely to return to work on time than smokers following this surgical procedure (Carpenter et al., 1996). Another trial, reported by Adams (2001), involving 140 smoking and 133 et al. non-smokers, found that the mean time to union of open tibial fractures was 32 weeks for smokers, compared with just 28 weeks for non-smokers. The authors also found that, in the same groups of patients, bone grafting was necessary in 36 smokers, but only 24 non-smokers required the procedure in order to stimulate bone healing (Adams 2001). These results were statistically significant et al., (P<0.05), and showed that smoking is deleterious to human fracture healing. The findings were consistent with other experimental studies, which also demonstrated
are more at risk of injury is unclear, although general weakness, inferior balance and poorer neuromuscular function have been identified as possible reasons (Kyro et al., 1993; Nelson et al., 1994; Sacks and Nelson, 1994). The adverse effects of smoking on fracture healing were reported in patients that underwent spinal fusion (spondylosyndesis or arthrodesis), with smokers generally having a higher rate of pseudoarthritis than the non-smoking control groups (40% vs. 8%) (Sloan et al., 2010). Several clinical studies have been carried out on human subjects regarding fracture healing and smoking (Whitesides et al., 1994; Silcox et al., 1995). Carpenter et al. (1996), reported that outcomes of lumbar fusion operations were significantly more favourable for non-smokers (P<0.02). The group also found that non-smokers were more likely to return to work on time than smokers following this surgical procedure (Carpenter et al., 1996). Another trial, reported by Adams et al. (2001), involving 140 smoking and 133 non-smokers, found that the mean time to union of open tibial fractures was 32 weeks for smokers, compared with just 28 weeks for non-smokers. The authors also found that, in the same groups of patients, bone grafting was necessary in 36 smokers, but only 24 non-smokers required the procedure in order to stimulate bone healing (Adams et al., 2001). These results were statistically significant (P<0.05), and showed that smoking is deleterious to human fracture healing. The findings were consistent with other experimental studies, which also demonstrated
PhDthesis_ANDREW_SLOAN.docx