SynthesisInternational journal of environmental research and public health2021
Delayed Tibial Shaft Fracture Healing Associated with Smoking: A Systematic Review and Meta-Analysis of Observational Studies Conducted Worldwide.
Synthesis in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Letter to the editor on: "Tibial tubercle involvement in tibial plateau fractures is associated with nonunion, reoperation, and flexion deficits".European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Association between visceral adiposity index and delayed union/nonunion after tibial or femoral shaft fractures: a single-center retrospective cohort study.BMC musculoskeletal disorders · 2026Article
- The impact of bone graft volume on risk of pseudarthrosis, screw loosening, and rod breakage in surgical correction of adult spinal deformity.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Development of a growth factor bioavailability enhanced allograft (GFBA) for bone regeneration.Cell and tissue banking · 2026Article
- Risk factors for delayed healing after traumatic limb fractures and a comparative assessment of external versus internal fixation in delayed union.American journal of translational research · 2026Article
- How to predict structural allograft survival in tibial reconstructions.Cell and tissue banking · 2025Article
- Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review.Bioengineering (Basel, Switzerland) · 2024Review
- Smoking and osteoimmunology: Understanding the interplay between bone metabolism and immune homeostasis.Journal of orthopaedic translation · 2024Review
- Risk factors for nonunion of osteoporotic vertebral compression fracture: a case‒control study.BMC musculoskeletal disorders · 2024Article
- Silencing p75NTR regulates osteogenic differentiation and angiogenesis of BMSCs to enhance bone healing in fractured rats.Journal of orthopaedic surgery and research · 2024Article
- Illicit drug abuse and complexity of tibial shaft fracture based on AO/OTA classification: Is there any connection?Journal of experimental orthopaedics · 2024Article
- Higher Modified Frailty Index Score is Associated with Increased 30-Day Postoperative Complications Following Surgical Treatment of Tibial Shaft Fractures.The archives of bone and joint surgery · 2024Article
- Predictors requiring special attention to prevent clavicle fracture nonunion: a systematic review of literature.Trauma surgery & acute care open · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tibial fractures represent a great burden of disease globally, being the most common long-bone fracture; smoking is a known risk factor for delayed skeletal healing and post-fracture complications. This systematic review and meta-analysis aims to analyse the effect of smoking on healing of tibial shaft fractures. PubMed, CINAHL, EMBASE, and Cochrane Library databases were searched from inception to March 2021, with no limitation on language, to find relevant research. All observational studies that assessed the association between cigarette smoking and tibial shaft fracture healing in adults (≥18 years) were included. The quality of studies was evaluated using the Newcastle Ottawa Quality Assessment Scale. A random effects model was used to conduct meta-analysis. Tobacco smoking was associated with an increased rate of non-union and delayed union as well as an increase in time to union in fractures of the tibial shaft. Among the 12 included studies, eight reported an increased rate of non-union, three reported delayed union, and five reported an increase in time to union. However, the results were statistically significant in only three studies for non-union, one for delayed union, and two studies for increased time to union. This review confirms the detrimental impact of smoking on tibial shaft fracture healing and highlights the importance of patient education regarding smoking cessation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.