Importance of fixing a Neck of Femur fracture in a bilateral amputee. Kareem Elsorafy, Brighton and Sussex University Hospital 26 May 2011 Dear Author, Thank you for your effort to explain a technique which helps with a challenge that can be met by any surgeon. It is obvious that there is some displacement in the fracture pre-operatively which has not changed post-operatively. I would like to know wether any traction was attempted during this procedure? If this was the case, then an assistant would have had to maintain traction for an average of thirty minutes and not be expected to fatigue. It may have been easier to pass a Schteinmenn through the distal femur to maintain traction throughout the procedure because it is easier to maintain a sustained continuous grip. The pin can then be attached to the traction device, available on DHS tables. It would have been also valuable to have x-rays of the lateral radiograph post-operatively to check the adequacy of the positioning technique in obtaining good quality images, since this was the main focus of the article. Finally, it is noted that the screw is positioned in a superior position rather than central position which is known to have the best quality bone (1). Reference: (1)The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip MR Baumgaertner, SL Curtin, DM Lindskog and JM Keggi The Journal of Bone and Joint Surgery, Vol 77, Issue 7 1058-1064, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc Competing interests I have had to apply traction to distal limb fractures and know how difficult it is to maintain traction for long periods.