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Updated: Oct 6, 2025
Comparing the Effects of Electronic Cigarette Vapor and Cigarette Smoke in a Novel In Vivo Exposure System
Published on: May 24, 2017
The Orthopedic Effects of Electronic Cigarettes: A Systematic Review and Pediatric Case Series
Maxwell Luke Armstrong1, Nicholas Smith1, Rhiannon Tracey2
1Division of Orthopedic Surgery, Janeway Children's Health and Rehabilitation Centre, Memorial University of Newfoundland, St. John's, NL A1B 3V6, Canada.
Abstract:
Electronic cigarette (EC) use is highly prevalent, especially in the adolescent population, where 29% of Canadian adolescents have used an EC in the past thirty days per national surveys. Our pediatric orthopedic referral centre observed a cluster of delayed unions of bone fractures in adolescents using ECs and present the case series here. We then asked whether electronic cigarettes impair bone healing or influence orthopedic outcomes. A PRISMA-compliant systematic review was carried out, which revealed no human clinical studies and a general paucity of evidence around ECs and musculoskeletal health. The existing experimental evidence relevant to orthopedics is summarized. The effect of ECs on the musculoskeletal system is poorly understood and is a target for further research.
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