Influence of Smoking in the Clinical Outcomes of Distal Radius Fractures

Abstract

Introduction There are various studies that reviewed the effect of cigarette smoking in fracture healing process. Nonunion, delayed union, and residual pain are the significant risk factors associated with smoking and fracture healing. Little has been known about the impact of smoking in distal radius fracture healing. We intend to explore in brief the effect of smoking in distal radius fracture healing and comparing it with nonsmokers having the same fracture fixation and analyze the outcomes with respect to fracture healing and return of function. Materials and Methods Of the total 186 patients, 92 were included in the study with (n = male: 31, female: 61) mean age of 60.2 years. They were divided into two groups: smoking (n = 43) and nonsmoking (n = 49). All had surgical fixation of the distal radius with volar locking plate and started on early mobilization. The range of motion of the wrist, grip, visual analog scale, quick disabilities of the arm and shoulder and hand score, Mayo wrist score, and bone healing period were noted between these two groups and compared with statistical analysis. Results The mean follow-up period was 8.7 months. There was a significant association of young age and male patients having distal radius fractures in the smoking group (p < 0.05). All fractures healed well in both groups without complications. There was no significant difference between these two groups in terms of range of motion, grasp, bone healing period, and functional outcomes. Conclusion Despite the well-known fact that, smoking has negative implications in the fracture healing process, we found group of patients (smoking and nonsmoking) with distal radius fractures treated by volar locking plates healed well with good radiological union and excellent functional outcome There is no significant influence of smoking in distal radius fracture fixation.

Distal Radius Fracture Subsidence after Nonoperative Treatment

“…The four American Academy of Orthopaedic Surgeons (AAOS) categories were used to classify preinjury functional demands: “normal” (can complete ADLs without any assistance), “independent” (can complete ADLs with assistive devices), “high” (place repeated high-energy stress to the wrist due to manual labor or athletic demands), or “homebound” (requiring human assistance to leave home). 21 We did not have any “homebound” patients in this study's cohort. Additionally, the mechanisms of injury were classified using the description of events leading to the DRF.…”

“…From an electronic medical record (EMR) review, patient data including demographics, preinjury functional demands, 19,20 energy of mechanism of injury, 22 smoking status, 21 and duration of immobilization were extracted. 25 Preinjury functional demands were determined using each patient's occupation, hobbies, and need for assistive devices for activities of daily living (ADLs) that were reported in the EMR.…”

“…Prior studies have reported specific demographic characteristics, injury types, and treatment variations to be associated with subsequent subsidence in nonoperatively treated DRFs. [19][20][21][22][23] However, the current published literature still lacks insight into specific radiographic patterns of DRF subsidence development, subsidence progression over time, and their relationships to known risk factors. In this article, we add to the current literature and close the knowledge gap further by examining the subsidence progression timeline and comparing its defining radiographic parameters.…”