Sir,I read with great interest the article by Kulkarni et al. titled “Management of thromboangiitis obliterans using distraction osteogenesis: A retrospective study,” published in Indian Journal of Orthopaedics.1 I would like to highlight a few important issues regarding this topic.By a simple definition, it is a disease of young males, often with unshod feet or poorly shod feet, who smoke Biris mostly a great deal, and have poor nutrition. The age group hovers between 20 and 35 years. Edema in feet and/or palpable popliteal artery is indicative of “fair” circulation in the background of TAO. At the level used for partial osteotomy, healing is quite likely. It does not indicate gross vascular deficiency.The author did not make any mention of the following:Poor nutrition before undertaking surgical intervention, Control of smoking, Improvement in nutrition, Buerger's exercise and Control of infection.A longish rest after the reported corticotomy, usual care with antibiotics and analgesics, control of infection, and control of anemia would certainly help anyway with the surgeon's academic pursuit in the methodology. The attention that the patient receives is expected to be very reassuring.