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- W-Dahl, Annette, et al.
(author)
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Cigarette smoking delays bone healing: A prospective study of 200 patients operated on by the hemicallotasis technique
- 2004
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In: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 75:3, s. 51-347
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Journal article (peer-reviewed)abstract
- Abstract in UndeterminedBackground Cigarette smoking is known to impede bone healing. The hemicallotasis technique is based on an external fixation and delayed healing prolongs treatment and increases the risk of further complications. Patients and methods 200 patients, 34 smokers and 166 nonsmokers, operated on by the hemicallotasis technique in the proximal tibia for deformities of the knee (knee arthrosis in 186 patients) were consecutively studied. We recorded their preoperative smoking habits, postoperative complications and the duration of treatment with external fixation. Results Half of the smokers and one fifth of the nonsmokers developed complications. Their mean time in external fixation was 96 (SD 20) days. Smokers required an average of 16 days more in external fixation. Delayed healing and pseudoarthrosis were commoner in smokers than nonsmokers. The risk ratio for smokers to develop complications was 2.5, as compared to nonsmokers.
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- W-Dahl, Annette, et al.
(author)
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No difference between daily and weekly pin site care: a randomized study of 50 patients with external fixation.
- 2003
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In: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 74:6, s. 704-708
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Journal article (peer-reviewed)abstract
- Introduction: We investigated whether there were any differences in the frequency and severity of pin site infections by performing pin site care daily or once a week. We studied patients operated on for gonarthrosis by the hemicallotasis technique, using hydroxyapatite-coated pins in the metaphyseal bone and standard pins in the diaphyseal bone. Patients and methods: 50 patients were prospectively randomized to daily (nÊ= 27) or weekly (nÊ= 23) pin site care. We evaluated pin sites, the occurrence of pain (VAS), the use of antibiotics and analgesics and complications every week. Bacterial cultures were taken from each pin site at 1, 6 and 10 weeks and from the pins on removal. Results: We found no differences between daily or weekly pin site care as regards the frequency and severity of pin site infections, pain, or the use of antibiotics and analgesics. Grade I infections (Checketts-Otterburns classification) occurred around 11% of the pins and grade II infections around 4%. 70% of the bacterial cultures were negative. The most frequent bacteria were coagulase negative staphylococcus and corynebacterium. Antibiotics were given an average of 47 days. More problems occurred around the proximal pins. 5/200 (all proximal) pins were clinically loose on removal. Interpretation: Pin site care once a week seems appropriate.
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