{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T12:44:01Z","timestamp":1785156241843,"version":"3.55.0"},"reference-count":113,"publisher":"Bioscientifica","issue":"11","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":1565,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This systematic review and meta-analysis aimed to analyse negative effects of smoking in orthopaedic and trauma patients. A PubMed search was carried out for studies published until July 2020 regarding effects of smoking on fracture risk, nonunion, infection after orthopaedic surgery, and persisting nonunion after scaphoid nonunion surgery. Random effects models calculated for outcome parameters, and relative risks (RR) with 95% confidence intervals are provided. No adjustments for covariates were made. Heterogeneity was assessed with Higgins\u2019 I2, publication bias with Harbord\u2019s p (Hp), sensitivity analysis performed on funnel plots and quality of studies was analysed using the Newcastle-Ottawa Scale. Of 3362 retrieved entries, 69 were included in the final analysis. Unadjusted RR for smokers to develop vertebral (six studies, seven entries; RR: 1.61; p = 0.008; I2 = 89.4%), hip (11 studies, 15 entries; RR: 1.28; p = 0.007; I2 = 84.1%), and other fractures (eight studies, 10 entries; RR: 1.75; p = 0.019; I2 = 89.3%) was significantly higher. Postoperative infection risk was generally higher for smokers (21 studies; RR: 2.20; p &amp;lt; 0.001; I2 = 58.9%), and remained upon subgroup analysis for elective spinal (two studies; RR: 4.38; p &amp;lt; 0.001; I2 = 0.0%) and fracture surgery (19 studies; RR: 2.10; p &amp;lt; 0.001; I2 = 58.5%). Nonunion risk after orthopaedic (eight studies; RR: 2.15; p &amp;lt; 0.001; I2 = 35.9%) and fracture surgery (11 studies; RR: 1.85; p &amp;lt; 0.001; I2 = 39.9%) was significantly higher for smokers, as was persisting nonunion risk after surgery for scaphoid nonunion (five studies; RR: 3.52; p &amp;lt; 0.001; I2 = 0.0%). Sensitivity analysis for each model reduced heterogeneity whilst maintaining significance (all I2 &amp;lt; 20.0%). Smoking has a deleterious impact on fracture incidence, and (subsequent) development of nonunions and postoperative infections.<\/jats:p>\n                  <jats:p>Cite this article: EFORT Open Rev 2021;6:1006-1019. DOI: 10.1302\/2058-5241.6.210058<\/jats:p>","DOI":"10.1302\/2058-5241.6.210058","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T07:39:35Z","timestamp":1637307575000},"page":"1006-1019","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":45,"title":["Fracture, nonunion and postoperative infection risk in the smoking orthopaedic patient: a systematic review and meta-analysis"],"prefix":"10.1530","volume":"6","author":[{"given":"Maria Anna","family":"Smolle","sequence":"first","affiliation":[{"name":"1Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Leitner","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"B\u00f6hler","sequence":"additional","affiliation":[{"name":"2Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz-Josef","family":"Seibert","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Glehr","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-2325","authenticated-orcid":false,"given":"Andreas","family":"Leithner","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"2026070711345178400_bibr1-2058-5241.6.210058","article-title":"London","volume-title":"Smoking and health: summary and report of the Royal College of Physicians of London on smoking in relation to cancer of the lung and other diseases","author":"Royal College of Physicians","year":"1962"},{"key":"2026070711345178400_bibr2-2058-5241.6.210058","article-title":"Smoking and health: report of the Advisory Committee to the Surgeon-General of the Public Health Service","author":"Bayne-Jones","year":"1964"},{"key":"2026070711345178400_bibr3-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1056\/NEJMra1308383","article-title":"Global effects of smoking, of quitting, and of taxing tobacco","volume":"370","author":"Jha","year":"2014","journal-title":"N Engl J Med"},{"key":"2026070711345178400_bibr4-2058-5241.6.210058","unstructured":"WHO. Age-standardized estimates of current tobacco use, tobacco smoking and cigarette smoking (Tobacco control: Monitor), 2018. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/gho-tobacco-control-monitor-current-tobaccouse-tobaccosmoking-cigarrettesmoking-agestd-tobagestdcurr (date last accessed 29 March 2021)."},{"key":"2026070711345178400_bibr5-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1001\/jama.1994.03520230035035","article-title":"Smoking, alcohol, and neuromuscular and physical function of older women","volume":"272","author":"Nelson","year":"1994","journal-title":"JAMA"},{"key":"2026070711345178400_bibr6-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00003086-199808000-00027","article-title":"Effect of nicotine on the rate and strength of long bone fracture healing","volume":"353","author":"Raikin","year":"1998","journal-title":"Clin Orthop Relat Res"},{"key":"2026070711345178400_bibr7-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1097\/00006534-197804000-00013","article-title":"Nicotine and its effect on wound healing","volume":"61","author":"Mosely","year":"1978","journal-title":"Plast Reconstr Surg"},{"key":"2026070711345178400_bibr8-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"850","DOI":"10.2106\/JBJS.L.00375","article-title":"The musculoskeletal effects of cigarette smoking","volume":"95-A","author":"Lee","year":"2013","journal-title":"J Bone Joint Surg [Am]"},{"key":"2026070711345178400_bibr9-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/jbmr.5650060404","article-title":"Smoking and bone loss among postmenopausal women","volume":"6-A","author":"Krall","year":"1991","journal-title":"J Bone Miner Res"},{"key":"2026070711345178400_bibr10-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"3575","DOI":"10.1210\/en.2002-220003","article-title":"3-Methylcholanthrene, which binds to the arylhydrocarbon receptor, inhibits proliferation and differentiation of osteoblasts in vitro and ossification in vivo","volume":"143","author":"Naruse","year":"2002","journal-title":"Endocrinology"},{"key":"2026070711345178400_bibr11-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"9","DOI":"10.5435\/00124635-200101000-00002","article-title":"The musculoskeletal effects of smoking","volume":"9","author":"Porter","year":"2001","journal-title":"J Am Acad Orthop Surg"},{"key":"2026070711345178400_bibr12-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1302\/0301-620X.89B12.19671","article-title":"Inhibition of fracture healing","volume":"89-B","author":"Gaston","year":"2007","journal-title":"J Bone Joint Surg [Br]"},{"key":"2026070711345178400_bibr13-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/j.lfs.2005.08.017","article-title":"Nicotine and lipopolysaccharide stimulate the formation of osteoclast-like cells by increasing macrophage colony-stimulating factor and prostaglandin E2 production by osteoblasts","volume":"78","author":"Tanaka","year":"2006","journal-title":"Life Sci"},{"key":"2026070711345178400_bibr14-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.12968\/bjcn.2003.8.Sup6.12554","article-title":"Nicotine, CO and HCN: the detrimental effects of smoking on wound healing","volume":"8","author":"Whiteford","year":"2003","journal-title":"Br J Community Nurs"},{"key":"2026070711345178400_bibr15-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/j.1365-2796.2003.01232.x","article-title":"Fracture risk associated with smoking: a meta-analysis","volume":"254","author":"Vestergaard","year":"2003","journal-title":"J Intern Med"},{"key":"2026070711345178400_bibr16-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00198-004-1640-3","article-title":"Smoking and fracture risk: a meta-analysis","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos Int"},{"key":"2026070711345178400_bibr17-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.surge.2019.08.003","article-title":"Risk factors of lateral epicondylitis: a meta-analysis","volume":"18","author":"Sayampanathan","year":"2020","journal-title":"Surgeon"},{"key":"2026070711345178400_bibr18-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"e010303","DOI":"10.1136\/bmjopen-2015-010303","article-title":"Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? 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The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp (date last accessed 5 January 2021)."},{"key":"2026070711345178400_bibr21-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1097\/BOT.0b013e318213f217","article-title":"The impact of smoking on complications after operatively treated ankle fractures: a follow-up study of 906 patients","volume":"25","author":"N\u00e5sell","year":"2011","journal-title":"J Orthop Trauma"},{"key":"2026070711345178400_bibr22-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"2026070711345178400_bibr23-2058-5241.6.210058","doi-asserted-by":"crossref","first-page":"3443","DOI":"10.1002\/sim.2380","article-title":"A modified test 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