We have compared the outcomes of the use of external fixation devices for spanning or sparing the ankle joint in the treatment of fractures of the tibial plafond, focusing on the complications and the rates of healing. We have devised a scoring system for the quality of reporting of clinical outcomes, to determine the reliability of the results.

We conducted a search of publications in English between 1990 and 2006 using the Pubmed search engine. The key words used were pilon, pylon, plafond fractures, external fixation. A total of 15 articles, which included 465 fractures, were eligible for final evaluation.

There were no statistically significant differences between spanning and sparing fixation systems regarding the rates of infection, nonunion, and the time to union. Patients treated with spanning frames had significantly greater incidence of malunion compared with patients treated with sparing frames. In both groups, the outcome reporting score was very low; 60% of reports involving infection, nonunion or malunion scored 0 points.

Aim: The evaluation of the reliability of the Oswestry disability questionnaire in postmenopausal women with osteoporosis and chronic back pain

Patients and method: 104 postmenopausal women with osteoporosis and low or upper back pain with during at least three months have been included in our study. The disability caused by the pain was estimated using Oswestry questionnaire and the pain intensity was estimated using VAS. The reported general condition of health had five interpretations: bad, not so good, satisfying, good, very good, graded by 0,1,2,3,4, respectively.

Results: Statistical significant correlations was found to be between disability and pain intensity in the low back pain group (r = 0.44, P < 0.0001), pain intensity in the upper back pain (r = 0.32, P < 0.01), and the reported general condition of health (r = 0.4, P < 0.001).

Conclusions: The reported statistical significant correlations increase the reliability of Oswestry questionnaire, and it can be used in the evaluation of the disability due to chronic back pain in postmenopausal women with osteoporosis.

Aim: The aim of our study is to show if there is any relation between scoliosis in the lumbar spine and osteoporosis in postmenopausal women.

Materials and Methods: In 46 postmenopausal women who, according to WHO’s criteria (T-score < −2,5 ), had osteoporosis in lumbar spine and hip and in 40 post-menopausal women with established osteoporosis (T score < −2,5 and at least and vertebral fracture) was estimated clinical and radiological the presence or not scoliotic bow in the lumbar spine. The bone density was measured with DEXA method in the lumbar spine and in the hip and the scoliosis was measured radiologically with Cobb’s method. To all patients has been done full biochemical examination to exclude secondary osteoporosis cases. The radiological examination included face and lateral x-ray of the lumbar and thoracic spine and that was done to detect vertebral fractures and to exclude women with other degenerative lesions. Also were excluded from our study women with primary or metastatic tumors in the spine.

Results: Out of 46 women who had osteoporosis 32 (69%) had scoliotic lumbar bow and in 23 (50%) patients the bow was more than 10 degrees. Out of 40 women who had established osteoporosis 26 (65%) had scoliotic lumbar bow and in 22 patients (55%) the bow was more than 10 degrees. In contrast in the control group of 25 normal postmenopausal women 5 women (20%) had scoliotic lumbar bow and in 2 women (8%) the bow was more than 10 degrees. Also in the group with the 32 osteopenic women (34%) had scoliotic lumbar bow and in 8 women (25%) the bow was more than 10 degrees. Finally in the group of 32 postmenopausal women with degenerative lesions without osteoporosis 13 (31%) had scoliotic lumbar bow and only in 6 (18%) the bow was more than 10 degrees.

Conclusions: After the statistical analysis of the results is evident that postmenopausal women who have osteoporosis have also scoliosis in the lumbar spine.