Introduction and Aims: Osteoporotic fractures, especially hip fractures, represent a major health problem in terms of morbidity, mortality and cost. Since the availability of new treatments for osteoporosis, a better understanding of the disease is needed to define the indications for treatment.

Method: A descriptive study of osteoporotic fractures and the evaluation of the relative risk of hip fracture following a minor fracture were done on a population aged 45 years old and older from 1980 to 1997 (2.5 million individuals, 1997).

Results: During the follow-up period, 220,120 fractures (hip, wrist, proximal humerus and ankle) were recorded. The incidence rate of fractures was stable over time. The wrist fracture was the most frequent (42.2%), followed by the hip fracture (32.5%). Although the proportions of fracture sites were similar for both sexes, 75% of the fractures occurred in females. The mortality rate one year after a hip fracture is increased by 14–27% for men and 9–13% for women after 60 years of age. Men and women aged 45 years old and older have a risk for hip fracture after a humerus or a wrist fracture of 2.3–17.3 time the risk of people without previous fracture.

Conclusion: Wrist and humerus fractures represent a major risk for future hip fracture, prevention of hip fracture should be revaluated regarding these new data and all these patients should be evaluated for osteoporosis and receive the appropriate treatment.

We reviewed 52 cases of osteomyelitis of the calcaneum. The clinical symptoms and signs were well defined, but different and less dramatic than those of long-bone osteomyelitis. Blood cultures were positive in 41% of cases and tissue cultures in 91%. Routine haematological tests were of little value, and radiological changes were often delayed, and were absent in 12%. With early diagnosis, treatment with antibiotics alone was usually effective, but complications and chronic disease were more likely if there was delay. Early diagnosis is the key to successful treatment. We describe a new physical sign and consider that diagnosis is almost always possible by clinical methods.