Meta-analysis of Clavicle Fractures in Smokers Makes a Strange Recommendation

Go out of your way to operate on smokers for a fracture that often heals? Something seems off here . . .

What’s the Claim?

We’re covering a study here whose main finding is common-sensical, but whose authors proffer a take-home message that struck us as upside-down.

A well-performed meta-analysis of eight generally well-designed source studies found that the relative risk of nonunion of displaced, middle-third clavicle fractures with nonsurgical treatment in people who smoke cigarettes is nearly 4x when compared to nonsmokers. That’s actually much higher than has been observed for many other fractures where this question has been considered. But that isn’t why we’re covering this one.