Aim of the study: We compared Aircast versus standard plastic cast immobilisation methods after ankle fractures surgery. Materials and methods: 32 patients who had had a low energy uni- or bimalleolar fracture were included into this prospective study in Kuopio University Hospital. They were randomised to use either standard cast or Aircast for 6 weeks after surgery. 18 patients (10 women and 8 men) average age 41 (20 – 63) years used Aircast and 14 patients (8 women and 6 men) average age 48 (19–69) years used standard cast. All fractures were treated operatively using standard A-O techniques. Patients were followed for 6 months; clinical and radiographic evaluation was carried out at nine and 26 weeks after surgery by senior doctors. The function of ankle joint after injury was evaluated as proposed by Kaikkonen et al. (Am J Sports Med 4:462–69, 1994). Results: All fractures healed without complications. There were no statistical difference between the study groups when evaluating the ability to walk or run, climbing down stairs, rising on heels or on toes with injured leg, single limb stance with injured leg, laxity of the ankle joint or range of foot dorsifl exion during the follow-up. The subjective assessment of the injured ankle was significantly better in the Aircast group nine weeks after the injury. In the Aircast group 13 patients had mild and 5 moderate symptoms but in the standard cast group 4 patients had mild, 9 moderate and 1 severe symptoms (p = 0.013). Rising on heels with injured leg was also remarkably different between the groups after nine weeks follow-up despite (p = 0.052). Conclusion: Aircast immobilisation seems to be safe method to immobilise ankle fractures after surgery. It seems to improve patient satisfaction and may not disturb function of ankle joint as much as the standard cast immobilisation.

Aim of the study: The aim of the study was to register and þnd out the longterm femoral bone response after insertion of femoral stem with or with-out cement. Materials and methods: Seventeen patients (7 men, 10 women) underwent cemented and 22 patients (14 men, 8 women) uncemented total hip arthroplasty (THA). The mean age in the cemented group was 69 (58–74) years and in the uncemented group 58 (46–68) years. Femoral bone mineral density (BMD) was measured using Lunar DPX or Lunar DPX-IQ densitometry according to zones by Gruen (ROI 1–7). BMD measurements were made preoperatively, and postoperatively over four to 14 days, and at 3, 6, 12, 24, and 36 months after THA. Postoperative BMD changes were calculated using the immediate postoperative BMD value as a reference, the change being expressed as a percent. Results: Peri-prosthetic BMD decreased signiþcantly almost in all ROIs during the þrst three months after both cemented (5–18%) and uncemented (3–14%) THA (p-values < 0.05 to p< 0.001). At the end of the þrst year the most remarkable decrease in BMD was found in the calcar (zone 7) in both groups (cemented 25%; uncemented 23%). Low preoperative bone loss predicted higher periprosthetic bone loss in both groups. From one to three year only small changes in periprosthetic BMD were detected after THA. Conclusions: The present study suggests that postoperative bone loss is equal after uncemented and cemented THA. The bone loss is most pronounced during the þrst six months after THA and mainly associated in proximal femoral bone. After the phase of acute bone loss, further loss is minimal after uncomplicated THA, reßecting merely the normal aging of bone. Patients with poor bone quality at baseline are at higher risk to lose bone around the prosthesis after THA.