Smoking status and the Disabilities of the Arm Shoulder and Hand score are early predictors of symptomatic nonunion of displaced midshaft fractures of the clavicle

Clement, Nicholas D.; Goudie, Ewan B.; Brooksbank, Andrew; Chesser, Tim; Robinson, C. M.

doi:10.1302/0301-620x.98b1.36260

Cited by 40 publications

(26 citation statements)

References 16 publications

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“…Similar findings were reported in elderly women; former and current smokers compared to nonsmokers had increased risk for fracture [ 59 , 71 ], including nonvertebral fractures in patients with diabetes (OR = 3.47, 95%CI: 1.82-6.62, P = 0.001) [ 61 ]. Regardless of fracture site, six cohort studies and one case-control study examining both sexes found smoking was significantly associated with poor fracture outcomes, such as nonunion ( P < 0.01) [ 57 , 58 , 60 , 66 ], lower trabecular strength (beta = -0.323; P = 0.045) and toughness (beta = -0.403; P = 0.018) [ 68 ], and delayed mean healing time [ 64 ]. No significant association was found between fracture and delay in filling [ 69 ] work absenteeism (P = 0.1177) [ 66 ] or low mental and physical-function scores on the Short Form 36 (SF-36) [ 66 ].…”

Section: Resultsmentioning

confidence: 99%

The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review

Al-Bashaireh

Haddad

Weaver

et al. 2018

Journal of Environmental and Public Health

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This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system. AMSTAR criteria were followed. A comprehensive search of PubMed, Web of Science, and Science Direct returned 243 articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system. In research on bones, smoking was associated with lower BMD, increased fracture risk, periodontitis, alveolar bone loss, and dental implant failure. In research on joints, smoking was associated with increased joint disease activity, poor functional outcomes, and poor therapeutic response. There was also evidence of adverse effects on muscles, tendons, cartilage, and ligaments. There were few studies on the musculoskeletal health outcomes of secondhand smoke, smoking cessation, or other modes of smoking, such as waterpipes or electronic cigarettes. This review found evidence that suggests tobacco smoking has negative effects on the health outcomes of the musculoskeletal system. There is a need for further research to understand mechanisms of action for the effects of smoking on the musculoskeletal system and to increase awareness of healthcare providers and community members of the adverse effects of smoking on the musculoskeletal system.

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Section: Resultsmentioning

confidence: 99%

The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review

Al-Bashaireh

Haddad

Weaver

et al. 2018

Journal of Environmental and Public Health

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“…concluded that TNF-α regulates cartilage resorption by inducing apoptosis in hypertrophic chondrocytes and recruiting osteoclasts [28] . Smoking impairs fracture healing, and nicotine is the main factor responsible for nonunion development in smokers [29] , [30] . Through the cholinergic antiinflammatory pathway, the secretion of TNF-α is inhibited by nicotine and the resorption of cartilage may be delayed [31] .…”

Section: Abnormal Cytokine Expressionmentioning

confidence: 99%

Molecular pathogenesis of fracture nonunion

Ding

Lin

Gan

et al. 2018

Journal of Orthopaedic Translation

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Fracture nonunion, a serious bone fracture complication, remains a challenge in clinical practice. Although the molecular pathogenesis of nonunion remains unclear, a better understanding may provide better approaches for its prevention, diagnosis and treatment at the molecular level. This review tries to summarise the progress made in studies of the pathogenesis of fracture nonunion. We discuss the evidence supporting the concept that the development of nonunion is related to genetic factors. The importance of several cytokines that regulate fracture healing in the pathogenesis of nonunion, such as tumour necrosis factor-α, interleukin-6, bone morphogenetic proteins, insulin-like growth factors, matrix metalloproteinases and vascular endothelial growth factor, has been proven in vitro, in animals and in humans. Nitric oxide and the Wnt signalling pathway also play important roles in the development of nonunion. We present potential strategies for the prevention, diagnosis and treatment of nonunion, and the interaction between genetic alteration and abnormal cytokine expression warrants further investigation.The translational potential of this articleA better understanding of nonunion molecular pathogenesis may provide better approaches for its prevention, diagnosis and treatment in clinical practice.

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“…During the course of the treatment, we assessed the patient's condition with X-ray, the Mayo elbow performance score (MEPS), [12,13] and the disabilities of the arm, shoulder, and hand (DASH) score (http://www.orthopaedicscore.com/scorepages/disabilities_of_arm_shoulder_hand_score_dash.html). [14,15] After 3 to 4 months of treatment, pain and disability related to the fracture were improved following healing of the left olecranon fracture in which there was no longer a displacement. No complications resulting from the fracture were observed during the follow-up period.…”

Section: Case Reportmentioning

confidence: 99%