The effect of substance abuse and smoking status on healing time of closed transverse femoral shaft fractures treated with open intramedullary nailing

Introduction Nonunion or delayed union is a known postoperative complication in long bone fractures. Substance abuse may impair bone healing. In this paper, we investigated the effect of narcotics on healing time in femoral shaft transverse fractures and the effect of substance abuse and smoking on postoperative healing time. Material and methods This cohort study was conducted at the Orthopedic Clinic of Poursina Hospital, Rasht from 2017-2019. Patients with transverse fractures of the femoral shaft who underwent intramedullary rod insertion were followed for 6 months. Bone healing time based on substance abuse and smoking status was evaluated. Results There was a significant association between various groups (categorized based on cigarette smoking and using drugs) in terms of bone healing status (P = ы0.006). There was a statistically significant difference in healing status among the control group, smoker group, and addict and smoker group (P = 0.034 and P = 0.004, respectively). However, there was no statistically significant difference in healing status between control and addicts group (P = 0.517). Conclusions Treatment efficiency and performance in addicted and smoker patients are more unfavorable and hence which, in turn, requires more follow-up periods; therapies such as bone grafting and other methods are more frequently considered in addicted and smoker patients in case of lack of healing reaction. Therefore, prevention plans in high-risk groups can play a significant role in primary identification, treatment, and reducing the complications of fractures.