title: Does smoking affect the quality of bone regenerate in paediatric limb reconstructive surgery?
abstract: OBJECTIVE
  To bring to the attention of the orthopaedic fraternity that adolescent children smoke and this has an adverse effect on the bone regenerate during limb deformity corrective surgery.
  
  
  METHODS
  Retrospective review of patients undergoing limb deformity corrective surgery with a prolonged frame time and bone-healing index. Patients operated on between 1993 and 2005 in a single regional specialist paediatric orthopaedic hospital.
  
  
  RESULTS
  Seventeen smoking patients (16 adolescent, one aged 9 years), with prolonged bone regenerate consolidation time of more than double the standard time. Bone-healing index (BHI) was increased in both active smokers and passive smokers.
  
  
  CONCLUSIONS
  In the older child/adolescent we should consider smoking (active or passive) as a detrimental factor in prolonging their frame times. We should council these patients and their carers to stop smoking at least during the period of their treatment.
authors.affiliation: Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, UK, rohan.rajan@nhs.net.
authors.forename: Rohan Ananda
authors.initials: RA
authors.lastname: Rajan
authors.forename: Ming
authors.initials: M
authors.lastname: Ong
authors.forename: Stanley
authors.initials: S
authors.lastname: Jones
authors.forename: James
authors.initials: J
authors.lastname: Fernandes