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Rapid response to:


Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial

BMJ 2014; 349 doi: (Published 24 July 2014) Cite this as: BMJ 2014;349:g4483

Rapid Response:

I read with interest the article by Griffin et al, BMJ 2014;349 (24 July 2014).

Smoking is known to be detrimental to wound healing and has been shown to be a risk factor for complications following calcaneus fracture surgery(1). 51% of patients within the operative arm of this study were smokers. There has been no sub-analysis of the results comparing smokers and non-smokers and I think that this is an important omission because of the high early complication rate. If smokers were excluded from the operative arm of this study how would this influence complication rate and outcome?

(1)Early Wound Complications of Operative Treatment of Calcaneus Fractures: Analysis of 190 Fractures. Journal of Orthopaedic Trauma: June/July 1999 - Volume 13 - Issue 5 - pp 369-372

Competing interests: No competing interests

21 November 2014
Richard D Cove
Consultant orthopaedic Surgeon
North Devon District Hospital, Barnstaple, Devon