- Email: [email protected]
Reply to the letter by Ashih Jaiman
Foot and Ankle Surgery 18 (2012) 77
Contents lists available at SciVerse ScienceDirect
Foot and Ankle Surgery journal homepage: www.elsevier.com/locate/fas
Letter to the Editor Reply to the letter by Ashih Jaiman
Disclosure of interest
Dear Colleagues,
The author declares that he has no conflicts of interest concerning this article.
I read with interest your pertinent comments about possible side effects of Vitamin C at 1000 mg for 45 days in prevention of Complex Regional Pain Syndrome type I in foot and ankle surgery [1]. When I began my prospective study in 2002, there were only two publications: the randomised study by Zollinger [2] using 500 mg Vitamin C and that of Cazeneuve [3] with 1000 mg. So I made the choice of 1000 mg for my study. As I clearly discussed in my article [1], three years after the end of our study, Zollinger published a second randomised study [4] comparing the prevention effect of three Vitamin C doses (200– 500–1500 mg) in wrist fractures, Zollinger found a dose effect with a prevalence of CRPS I of 10.1% in his placebo group, 4.2% in the 200-mg group, 1.8% in the 500-mg group and 1.7% in the 1500-mg group, and finally concluded that a daily dose of 500 mg for fifty days is to be recommended. But as our study used a 1000 mg Vitamin C protocol for Foot and Ankle surgery, it is logical for us to recommend this dose. For six years, our orthopaedic and traumatologic department has used this protocol for all operations. We can estimate that more than 10,000 patients received this 1000 mg Vitamin C prevention and we never observed any adverse effects. We only checked history of (uric acid) kidney stone. However I agree that in light of the last Zollinger publication [4], 500 mg of Vitamin C is probably enough.
References [1] Besse JL, Gadeyne S, Galand-Desme S, Lerat JL, Moyen B. Effect of Vitamine C on prevention of Complex Regional Pain Syndrome type I in Foot and Ankle surgery. Foot Ankle Surg 2009;15(4):179–82. [2] Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 1999;354:2025–8. [3] Cazeneuve JF, Le Borgne JM, Kermad K, Hassan Y. Vitamin C and prevention of reflex sympathetic dystrophy following surgical management of distal radius fractures. Acta Orthop Belg 2002;68:481–4. [4] Zollinger PE, Tuinebreijer WE, Breederveld RS, Kreis RW. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose–response study. J Bone Joint Surg Am 2007;89:1424–31.
Jean-Luc Bessea,b,* Universite´ Lyon 1, IFSTTAR, LBMC UMR-T 9406 – Laboratoire de Biome´canique et Me´canique des Chocs, 69675 Bron Cedex, France b Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de chirurgie Orthope´dique et Traumatologique, 69495 Pierre-Be´nite Cedex, France a
*Correspondence address: Centre Hospitalier Lyon-Sud, Service de chirurgie Orthope´dique et Traumatologique, 69495 Pierre-Be´nite Cedex, France. Tel.: +33 4 78 86 14 27; fax: +33 4 78 86 59 34 E-mail address: [email protected] (J.-L. Besse)
DOI of original article: 10.1016/j.fas.2010.05.008 1268-7731/$ – see front matter ß 2011 Published by Elsevier Ltd on behalf of European Foot and Ankle Society. doi:10.1016/j.fas.2011.10.004
Contents lists available at SciVerse ScienceDirect
Foot and Ankle Surgery journal homepage: www.elsevier.com/locate/fas
Letter to the Editor Reply to the letter by Ashih Jaiman
Disclosure of interest
Dear Colleagues,
The author declares that he has no conflicts of interest concerning this article.
I read with interest your pertinent comments about possible side effects of Vitamin C at 1000 mg for 45 days in prevention of Complex Regional Pain Syndrome type I in foot and ankle surgery [1]. When I began my prospective study in 2002, there were only two publications: the randomised study by Zollinger [2] using 500 mg Vitamin C and that of Cazeneuve [3] with 1000 mg. So I made the choice of 1000 mg for my study. As I clearly discussed in my article [1], three years after the end of our study, Zollinger published a second randomised study [4] comparing the prevention effect of three Vitamin C doses (200– 500–1500 mg) in wrist fractures, Zollinger found a dose effect with a prevalence of CRPS I of 10.1% in his placebo group, 4.2% in the 200-mg group, 1.8% in the 500-mg group and 1.7% in the 1500-mg group, and finally concluded that a daily dose of 500 mg for fifty days is to be recommended. But as our study used a 1000 mg Vitamin C protocol for Foot and Ankle surgery, it is logical for us to recommend this dose. For six years, our orthopaedic and traumatologic department has used this protocol for all operations. We can estimate that more than 10,000 patients received this 1000 mg Vitamin C prevention and we never observed any adverse effects. We only checked history of (uric acid) kidney stone. However I agree that in light of the last Zollinger publication [4], 500 mg of Vitamin C is probably enough.
References [1] Besse JL, Gadeyne S, Galand-Desme S, Lerat JL, Moyen B. Effect of Vitamine C on prevention of Complex Regional Pain Syndrome type I in Foot and Ankle surgery. Foot Ankle Surg 2009;15(4):179–82. [2] Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 1999;354:2025–8. [3] Cazeneuve JF, Le Borgne JM, Kermad K, Hassan Y. Vitamin C and prevention of reflex sympathetic dystrophy following surgical management of distal radius fractures. Acta Orthop Belg 2002;68:481–4. [4] Zollinger PE, Tuinebreijer WE, Breederveld RS, Kreis RW. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose–response study. J Bone Joint Surg Am 2007;89:1424–31.
Jean-Luc Bessea,b,* Universite´ Lyon 1, IFSTTAR, LBMC UMR-T 9406 – Laboratoire de Biome´canique et Me´canique des Chocs, 69675 Bron Cedex, France b Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de chirurgie Orthope´dique et Traumatologique, 69495 Pierre-Be´nite Cedex, France a
*Correspondence address: Centre Hospitalier Lyon-Sud, Service de chirurgie Orthope´dique et Traumatologique, 69495 Pierre-Be´nite Cedex, France. Tel.: +33 4 78 86 14 27; fax: +33 4 78 86 59 34 E-mail address: [email protected] (J.-L. Besse)
DOI of original article: 10.1016/j.fas.2010.05.008 1268-7731/$ – see front matter ß 2011 Published by Elsevier Ltd on behalf of European Foot and Ankle Society. doi:10.1016/j.fas.2011.10.004