Purpose: We assess the results of the surgical treatment of intra-articular fractures of the calcaneus using the Ilizarov external fixator.

Materials and Methods: During the period of January 2004 to June 2009 we treated 72 intra-articular calcaneus fractures in 68 patients, 51 male and 17 female with a mean age of 34 (range 18–56). The mean follow –up period was 2 years and 10 months (range 3 months to 4 years). All patients received preoperative CT-scan to facilitate classification and pre-operative planning. Of the 72 fractures, 37 (51.4%) were Sanders type II, 30 (41.6%) were type III and 5 (7%) were type IV.

The Ilizarov fixator used consisted of 2 rings positioned above the ankle joint and a foot plate. 1.5 and 1.8 mm wires were used, as well as 1.8 mm wires with an olive for the reduction of displaced fragments. Under image intensification and distraction the fracture was reduced and the articular surface was restored as close as possible.

Results: The clinical outcome was excellent in 29 patients (40.4%), good in 32 (44.4%), moderate in 7 (9.7%) and poor in 4 (5.5%). As far as the complications are concerned, we had 17 cases of pin track infection treated with the removal of the pins, ankle joint stiffness in 12 patients treated with physiotherapy, 2 patients developed reflex sympathetic algodystrophy, 2 malunion, 8 developed post-traumatic osteoarthritis and 1 of them underwent subtalar arthrodesis.

Conclusion: The use of the Ilizarov external fixator for the treatment of intra-articular calcanear fractures has proved itself to be an alternative method to O.R.I.F with similarly good results. Given the fact that the learning curve is relatively steep, it has proven, from our experience, to be a safe and valuable tool for the treatment of these challenging fractures.

Purpose: To check the accuracy of the Internet-derived medical information.

Materials and Method: We tested the validity of randomly chosen Internet-derived statements concerning four common orthopaedics problems. Two-hundred statements were gleaned by two nonmedical persons from 30 chosen websites, after employing a common search engine. Fifty statements were derived on each of four separate topics (knee osteoarthritis, hip osteoarthritis, low back pain, and osteoporosis). Five residents in orthopaedic surgery were then asked, to independently rank the accuracy of these statements using a five point rating scale with 1 being strongly disagree to 5 being strongly agree with the statement. Means were then obtained for each question and ranked on validity with > 4 being very valid, > 3 being somewhat valid and < 3 being invalid.

Results: Overall score for the 200 statements was 3.81 with 61% deemed very valid, 20% deemed somewhat valid and 19% deemed invalid. For knee osteoarthritis, the overall score was 3.63 with 63% being very valid, 18% being somewhat valid and 19% being deemed invalid. For hip osteoarthritis, the overall score was 3.75 with 58% being very valid, 21% being somewhat valid and 19% deemed invalid. For low back pain, the overall score was 3.91 with 48% being very valid, 36% being somewhat valid and 16% deemed invalid. For osteoporosis, the overall score was 3.96 with 59% being very valid, 18% being somewhat valid and 23% deemed invalid.

Conclusion: Approximately 20% of medical information found on the Internet is misleading and, invalid. Patients and physicians who use the Internet to access health information, should be aware of these inaccuracies and better seek advice from reliable medical web sites of universities.

Purpose: To evaluate the modification of the hump in patients with idiopathic scoliosis after the use of Boston brace and to compare this with the change of the Cobb angle.

Material – Methods: Prospective study of 60 female patients with idiopathic scoliosis who were treated with the application of Boston brace. The average age was 12,8 years ( 9–15 years ) and the average Kisser sign was 1,5. According to King classification 14 (23.5%) patients met the criteria for type I, 21 (35%) for type II, 13 (21.5%) for type III and 12 (20%) for type IV .No patients with type V curves were included. The average Cobb angle was 22°. The patients were reviewed every six months with clinical examination, plain x-rays at erect position and twelve hours after the removal of the brace The patient’s hump was evaluated with the use of a special equipment (formulator), it was imprinted on a chart and the hump gradient was measured. The time of brace application was recorded.

A small group of 15 patient with scoliosis less than 15°, was used as control group. A Boston brace was notn applied to this patients.

T -test and x square test were used for statistical analysis.

Results: The follow-up period was on average 25 months. The brace was applied for 18–20 hours in 24-hours with the tendency of gradual decrease of the time of the application as the patient was getting older. An average decrease of 13,5% of the hump gradient was found after using the Boston brace. This was 17% for King type I, 22.29%, for King type 1lo 9.73% for King type III and 1.19% for King type IV. The average increase of the Cobb ankle was 2, 6 .

Conclusion: The application of the Boston brace in patients with idiopathic scoliosis seems to improve the pattern of the hump, mainly in type II and III patterns and less in type IV.