Author’s reply

We appreciate Dr Carr's comments.The patients in our review were instructed to remain non-weight-bearing until the fracture had healed, but we did not place them in a long-leg cast to enforce this.This would have resulted in functional disability for these often elderly patients which might have precluded discharge from hospital.It is difficult to comment on his specific surgical technique.In our review, patients were treated using AO principles, but it is possible that special techniques are necessary in subgroups of patients.The main point of our article was to recognise that foot and ankle injuries in diabetics have different risks and prognosis.Some form of prospective trial would be needed to define better the optimal form of treatment.