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Hip: P. Mattsson, A. Alberts, G. Dahlberg, M. Sohlman, H. C. Hyldahl, and S. Larsson Resorbable cement for the augmentation of internally-fixed unstable trochanteric fractures: A PROSPECTIVE, RANDOMISED MULTICENTRE STUDY J Bone Joint Surg Br 2005; 87-B: 1203-1209 [Abstract] [Full text] [PDF]

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Response to Mr Kharwadkar

Production Department   (20 October 2005)

Letter from Mr Kharwadkar

Nikhil Kharwadkar   (14 October 2005)

Response to Mr Kharwadkar 20 October 2005
Production Department Send letter to journal: Re: Response to Mr Kharwadkar production{at}jbjs.org.uk Production Department	The authors have chosen not to respond to this letter.
Letter from Mr Kharwadkar 14 October 2005
Nikhil Kharwadkar, SpR Yorkshire Deanery Send letter to journal: Re: Letter from Mr Kharwadkar nkharwadkar{at}hotmail.com Nikhil Kharwadkar	Sir, I read this article with interest. Osteoconductive materials like calcium phosphate cement have been shown to be effective in the treatment of defects in metaphyseal bone in association with some fractures, notably in the distal radius, the tibial plateau and the calcaneum.1 The use of calcium phosphate cement for unstable trochanteric fractures has provided a modest reduction in pain and a slight improvement in quality of life during the course of healing. However, the authors have not commented on improved stability of the fixation with the use of calcium phosphate cement. Interestingly, two fractures in the augumented group had not healed completely on the radiograph at six months and were therefore classified as nonunion. The authors have also reported two cases of loosening of the plate due to breakage and pulling out of screws by six months in the augumented group. Calcium phosphate cement provides a structural support to the adjacent bone and therefore acts as an adjunct to limit the amount of fixation.1 Deep infection may have caused the failure of fixation in these two cases. The authors have not mentioned the incidence of superficial or deep infection for both groups. N. KHARWADKAR, MRCS, MS Yorkshire Deanery, Leeds, UK. 1. Keating JF, McQueen MM. Substitutes for autologous bone graft in orthopaedic trauma. J Bone Joint Surg [Br] 2001;82-B:3-8.