Both obesity and smoking can have negative effects on bone health, say researchers, adding they also impact healing in patients who have undergone surgery for fractures of the wrist, or the distal radius, among the most common bone fractures.
"Obesity and smoking are currently considered among the two most important preventable causes of poor health in developed nations, and both are modifiable risk factors," said senior author Tamara D. Rozental from Harvard University.
For the study, published in the Journal of Hand Surgery, the research team analysed data on patients surgically treated for a distal radius fracture between 2006 and 2017 at two trauma centers.
The 200 patients were divided into obese and non-obese groups (39 and 161 patients, respectively) and were also characterized as current, former, and never smokers (20, 32, and 148 patients, respectively) based on self-reported cigarette use.
At three-month and one-year follow-ups after surgery, both the obese and non-obese groups achieved acceptable scores that pertained to patient-reported function in the upper extremity - close to those of the general population.
The two groups were also similar in regards to range of motion and bone alignment.
At three months, smokers demonstrated worse scores related to arm, shoulder, and hand function and a lower percentage of healed fractures, but these effects improved over the course of a year.
Complications were similar between groups.
"Overall we found that we can achieve excellent clinical and radiographic outcomes with surgery for displaced wrist fractures in patients who are obese and in those who smoke," said Rozental.
The results show that treatment for distal radius fractures in obese and smoking patients is safe, and these patients may be treated like the general population with similar long-term results.
Their short-term outcomes, however, demonstrate higher disability and, in the case of smokers, slower fracture healing," Rozental added.
"As such, we believe that lifestyle interventions focusing on weight loss and smoking cessation should be emphasized whenever possible," she said.
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