When Toronto surgeon Michael McKee told the recent annual meeting of the American Academy of Orthopedic Surgeons that the complex Ilizarov procedure is unsuitable for smokers, the response was rapid.
When newspaper reports about the meeting appeared, he told CMAJ, his office was inundated with email. About 75% of writers supported him, but one called him “Satan” and another threatened “to report him to the college.”
“Something got lost in the translation,” McKee says of his research, which determined that the failure rate for smokers (30%) is much higher than for nonsmokers (8%). “All I said was that for this one elective procedure, let's give it the best possible chance of success. I'm not trying to be punitive — I'm just asking for a 6-month window of opportunity in which they quit smoking.”
The Ilizarov procedure, a complex and time-consuming operation in which a metal frame is used to lengthen bone, is commonly used to treat congenital deformities and malunited fractures.