The Effects of Smoking on Bone Healing

We all know the negative effects of smoking. We all know that smoking is highly related to various cancers, increases the chances of stroke and heart attack, and even causes wrinkles. What you might not realize, however, is that smoking can affect the way our bones heal. This means that if you are a smoker and break a bone, or decide to have orthopedic surgery; your body’s ability to heal itself is greatly diminished. When a bone takes too long to heal, this is called delayed union. When there is complete absence of bony healing, we refer to this as non-union. Both these scenarios can lead to the need for multiple surgical procedures and significant long-term complications.

Bone, like any other part of the human body requires a good blood supply to survive. When bone is damaged, its requirement for this blood supply is significantly enhanced. Nicotine causes restriction of blood vessels, and therefore the supply of nutrient rich blood to the bone is cut off. Smoking can also contribute to osteoporosis and weaken the overall structure of bone.

Osteoblasts are the cells that create new bone. Smoking damages these cells and again, prevents the bone from growing stronger and faster than it should. This can not only cause delay in healing, but can put the bone at risk for re breaking. Many other toxins exist in cigarettes that can affect bone and its ability to mend. Bones carry stem cells, which are vital components in the healing process. Some even believe that these toxins damage the stem cells within the bone marrow. The cells in the bone marrow that are harmed by smoking are also responsible for healing of every other organ. Therefore, when a smoker undergoes surgery, the capacity for the skin incision to heal well is reduced. This also results in a higher risk for a wound infection. This infection, if severe enough, can spread to the bone and cause it to be infected as well. This can lead to the need for long term intravenous antibiotics and even puts patients at risk for amputation.

If it isn’t obvious enough, the point we are trying to make is this… stop smoking! Aside from all the other terrible affects it has on your general health; your bones will suffer too. If you do smoke and happen to break a bone, it is in your absolute best interest to refrain from picking up that cigarette. Likewise, if you are even remotely considering having any sort of surgery and want to have the best outcome possible without major complications, you might want to think twice about taking that drag. Do yourself a favor and talk to your surgeon or primary care doctor about smoking cessation options. It may seem impossible at first, but you will thank yourself for it later.

Dr. Gary B. Briskin, DPM, FACFAS

Dr. Gary B. Briskin, DPM, FACFAS

As co-founder and co-director of University Foot and Ankle Institute, board-certified Dr. Gary Briskin began his medical training by serving a residency at Flint General Hospital in Michigan. Once completed, he established a practice in Century City Hospital, where he soon became chief of podiatric surgery.

Dr. Briskin is a Diplomat of the American Board of Podiatric Surgery and a Fellow of the American College of Foot and Ankle Surgeons. He also serves as an assistant clinical professor at the UCLA School of Medicine.
Dr. Gary B. Briskin, DPM, FACFAS

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