Effects of smoking on healing of distal femur intra articular fractures, treated with distal femur locking compression plate

  • Shukla R Department of Orthopedics, Department Of Orthopedics-SAMC and PGI, Indore, Madhya Pradesh, India
  • Jain N Department of Orthopedics, Department Of Orthopedics-SAMC and PGI, Indore, Madhya Pradesh, India
  • Jain R Department of Orthopedics, Department Of Orthopedics-SAMC and PGI, Indore, Madhya Pradesh, India
  • Sheikh T Department of Orthopedics, Department Of Orthopedics-SAMC and PGI, Indore, Madhya Pradesh, India
  • Baxi M. Department of Orthopedics, Department Of Orthopedics-SAMC and PGI, Indore, Madhya Pradesh, India
Keywords: Distal Femur Locking Compression plate, Fracture, Union time, Smoking

Abstract

Background: The aim of this study was to identify the effect of smoking on bone healing and other complications encountered in treatment and follow up of distal femur fracture.

Methods: A total of 54 patients with AO type B and C Distal femur fracture were included during the study period. All the patients were treated with distal locking compression plating. Functional outcome was recorded on the basis of American knee society scoring system.

Results: The mean radiological union time and incidence of post-operative infection was significantly higher in smoker as compared to non-smokers. Total American knee society score was similar in both the groups.

Conclusion: Smoking affects the fracture union in distal femur fracture patients. Smokers have more infection rate and more stiffness compared to non- smokers. It is recommended to stop smoking during fracture treatment.

Downloads

Download data is not yet available.

References

1. Arneson TJ, Melton LJ, Lewallen DG. Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965 Clin Orthop Relat Res. 1988;234:188-94.

2. Schatzker J. Fractures of distal femur revisited. Clin Orthop Relat Res 1998; 347 : 43-56

3. Malik I, Khan R, Khurana R, Sharma S. Comparative study of management of distal femoral fractures managed by dynamic condylar screw and distal femoral locking compression plate. Webmed Central ORTHOPAEDICS 2015;6(9):WMC004976.

4. Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18:488–93

5. Gardner MJ, Helfet DL, Lorich DG. Has locked plating completely replaced conventional plating? Am J Orthop (Belle Mead NJ) 2004;33:439–46.

6. Gardner MJ, Brophy RH, Campbell D, Mahajan A, Wright TM, Helfet DL, et al. The mechanical behavior of locking compression plates compared with dynamic compression plates in a cadaver radius model. J Orthop Trauma. 2005;19:597–603.

7. Cordey J, Borgeaud M, Perren SM. Force transfer between the plate and the bone: Relative importance of the bending stiffness of the screws friction between plate and bone. Injury. 2000;31(Suppl 3):C21–8.

8. Singh AK, Rastogi A, Singh V. Biomechanical comparison of dynamic condylar screw and locking compression plate fixation in unstable distal femoral fractures: An in vitro study. Indian J Orthop. 2013;47(6):615-20.

9. Pakuła G, Kwiatkowski K, Kuczmera P, Fudalej P. Assessment of Outcomes of Treatment of Fractures of Distal Femur with a Locking Plate Taking into Account Factors Influencing the Result. Ortop Traumatol Rehabil. 2015;17(5):501-11.

10. Henderson CE, Kuhl LL, Fitzpatrick DC, Marsh JL. Locking plates for distal femur fractures: is there a problem with fracture healing? J Orthop Trauma. 2011; Suppl 1:S8-14.

11. Trivedi NP, Chauhan RH, Padhiyar DR, Gandhi PS. Outcome of fracture of intra articular distal femur treated with distal femur locking compression plate. Int J Res Orthop. 2015 Dec;1(1):22-27

12. Schandelmaier P. Distal femoral fractures and LISS stabilization. Injury Int Care Injured. 2009; 32 S-C : 55-63.

13. Markmiller M konard G and Sudkamp N. femur-LISS and Distal Femoral Nail for fixation of distal femoral fractures. Clin Orthop 2004; 426:252-7.

14. Hernigou J, Schuind F. Smoking as a predictor of negative outcome in diaphyseal fracture healing. Int Orthop. 2013;37(5):883-7.

15. Castillo RC, Bosse MJ, MacKenzie EJ, Patterson BM. Impact of smoking on fracture healing and risk of complications in limb threatening open tibia fractures. J Orthop Trauma 2005; 19(3):151–157

16. Harvey EJ, Agel J, Selznick HS, Chapman JR, Henley MB. Deleterious effect of smoking on healing of open tibia-shaft fractures. Am J Orthop 2002;31(9):518–521

17. Hoogendoorn JM, van der Werken C. The adverse effects of smoking on healing of open tibial fractures. Ned Tijdschr Geneeskd 2002; 146(35):1640–1644

18. Giannoudis PV, MacDonald DA, Matthews SJ, et al. Nonunion of the femoral diaphysis: the influence of reaming and non-steroidal anti-inflammatory drugs. J Bone Joint Surg [Br] 2000;82-B:655–658.

19. Schenker ML, Scolaro JA, Yannascoli SM, Baldwin KD, Mehta S, Ahn J. Blowing Smoke: A Meta Analysis of Smoking on Fracture Healing and Post Operative Infection. 2013 American Academy of Orthopaedic Surgeons annual meeting in Chicago.

20. Cryer PE, Haymond MW, Santiago JV, Shah SD Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events. N Engl J Med 1976 ; 295 : 573-577.

21. Jensen JA, Goodson WH, Hopf HW, Hunt TK. Cigarette smoking decreases tissue oxygen. Arch Surg 1991 ; 126 : 1131-1134.

22. Michaud SE, Dussault S, Groleau J, Haddad P, Rivard A. Cigarette smoke exposure impairs vegFinduced endothelial cell migration : role of nO and reactive oxygen species. J Mol Cell Cardiol 2006 ; 41 : 275-284.

23. Castillo RC1, Bosse MJ, MacKenzie EJ, Patterson BM; LEAP Study Group. Impact of smoking on fracture healing and risk of complications in limb-threatening open tibia fractures. J Orthop Trauma. 2005 Mar;19(3):151-7.

24. Adams CI, Keating JF, Court-Brown CM. Cigarette smoking and open tibial fractures. Injury 2001; 32(1):61–65.
Published
2018-06-30
CITATION
DOI: 10.5281/zenodo.3970131
Published: 2018-06-30
How to Cite
1.
Shukla R, Jain N, Jain R, Sheikh T, Baxi M. Effects of smoking on healing of distal femur intra articular fractures, treated with distal femur locking compression plate. ojmpc [Internet]. 2018Jun.30 [cited 2024Nov.21];24(1):21-4. Available from: https://ojmpc.com/index.php/ojmpc/article/view/64
Section
Original Article