Comment on Hernigou and Schuind: smoking as a predictor of negative outcome in diaphyseal fracture healing
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LETTER TO THE EDITOR
Comment on Hernigou and Schuind: smoking as a predictor of negative outcome in diaphyseal fracture healing Jacques Hernigou & Frédéric Schuind
Received: 1 March 2013 / Accepted: 2 March 2013 / Published online: 21 March 2013 # Springer-Verlag Berlin Heidelberg 2013
Dear Liang Ding and colleagues, Thank you for your letter [1] regarding our article [2]. Indeed, infection is a well-known factor impairing bone healing. In the series presented in our article [2], we have not included the septic nonunions, which is probably not clearly stated in our publication. Septic nonunions have been indeed quite rare in our experience, as we treat most open fractures by external fixation, seldom use plate fixation—especially in distal tibia fractures which can be complicated by skin necrosis and subsequent bone infection—and apply a strategy of early flap coverage in open fractures. In the series of 38 nonunions studied in the article, none has been considered to be septic. Sincerely yours, J. Hernigou – F. Schuind
J. Hernigou (*) : F. Schuind Orthopaedic and Traumatology Department, Université Libre de Bruxelles – Erasme Hospital, Brussels, Belgium e-mail: [email protected]
References 1. Ding L, He Z, Xiao H, Xue F (2013) Comment on Hernigou and Schuind: smoking as a predictor of negative outcome in diaphyseal fracture healing. Int Orthop. doi:10.1007/s00264-013-1860-2 2. Hernigou J, Schuind F (2013) Smoking as a predictor of negative outcome in diaphyseal fracture healing. Int Orthop 1:1. doi:10.1007/ s00264-013-1809
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