A study was undertaken of externally fixed tibial fractures in which a fracture stiffness of greater than 15Nm/° was used to define when the frame was removed were included 37 patients were studied; 20 (54%) non-smokers and 17 (46%) smokers. The two groups were comparable (ANOVA p=0. 35) for other factors.

Mean healing times in the non-smokers was 15. 5 weeks and in smokers was 21. 2 weeks (t-test p=0. 05).

We encourage all patients with tibial fractures to stop smoking by quoting an increase of treatment time of six weeks.