Aim: To test the hypothesis that the number of admissions in an orthopaedic trauma ward are related to weather conditions.

Materials and Methods: Details of all admissions to the orthopaedic trauma ward over one complete year were retrieved from a computerised data base. Fractures were classified according to the AO classification.

Meteorological data correlated with trauma admissions and data analysis using SPSS version 10.1

Results: Total number of admissions = 1390 [mean age: male=44.2, female=67.6 years]. Commonest fractures in descending order: neck of femur, distal tibia and distal humerus. Overall correlation: significantly +ve (p=0.013) with sunshine (more sunshine = more fractures) and significantly –ve (p=0.001) with rain (less rain = more fractures). 34.5% of admissions were non trauma related.

Conclusion: Females were significantly older than men probably reflecting hazardous activities by younger males and the presence of osteopaenia in females. No significant monthly (seasonal) variations were seen. Influence of weather conditions:

Proximal femoral fracture incidence increase with fall in temperature (freezing conditions does NOT further increase the risk) and rain (but NOT dependent on the amount of rain).

A long term prospective study is required to further support the above findings if clinical trauma resources are to be planned based on predicted weather forecast.

Introduction and aim: The resemblance of acute osteomyelitis and primary bone tumor is well established. However, pubic osteomyelitis presents particular diagnostic dilemmas and acute osteomyelitis of the distal femur resembling soft tissue sarcoma has not previously reported in the English literature.

Patients and methods: We report two cases of acute osteomyelitis in 6-year and 7-year old children, affecting the pelvis and the distal femur respectively. Both patients reported previous trauma and presented with a painful limp. Clinical examination revealed a painful mass in both. Laboratory screening and imaging modalities were inadequate to establish the correct diagnosis.

Results: ESR and CRP were raised in both patients, however blood cultures were negative. Plain x-rays showed a lytic lesion at the pelvic site and were unremarkable for the femur. Bone scan was not specific. MRI Scan suggested primary bone tumor in both cases, i.e. Ewing’s sarcoma and liposarcoma/rabdomyosarcoma respectively. Open biopsy established the correct diagnosis and S. Aureous was isolated in both cases. Treatment was conservative

Conclusion: Acute osteomyelitis may cause diagnostic confusion especially if its location and/or presentation are particularly unusual. Blood investigations are frequently inconclusive. Even the most sophisticated imaging modalities may fail to establish the diagnosis and biopsy is then necessary. This should be always performed in specialized centers, in order to minimize complications. Treatment is fairly straightforward.