Adams et al 7 showed a trend for increasing times to union in open tibia fractures from Gustilo grade I to IIIA, but the trend did not continue into IIIB subtypes.
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Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? A systematic review with meta-analysis.
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Andersen et al showed that fusion rate was higher in patients who gave up smoking postoperatively and Glassman et al observed a trend towards significance in those who gave up for longer than 6 months. 20 21 It has been suggested that the greater the number of cigarettes smoked, the longer the healing time. 5 68 The question of how long a patient should abstain from smoking following injury is difficult to answer and may depend on how long a patient has been a smoker.