Aim: Evaluation of health-related quality of life in scoliotic patients as compared to age matched general population individuals. Correlation with the curve degree and the method of treatment.

Material – method: Ninety patients with idiopathic scoliosis were interviewed. The assessment included: a) the SF-36 questionnaire, evaluating general health status, b) Specific Quality of Life Instrument, designed and validated for adolescents with spinal deformities, c) Postoperative Patients Satisfaction Score, for patients operated on for scoliosis. Patients were subdivided to three groups according to the curve degree and method of treatment: Group A, patients with curves < 20o, treated with observation and regular follow up. Group B, curves between 20o and 40o, treated with a Boston brace. Group C, curve > 40o, operative treatment.

Results: SF – 36 physical health summaries were not significantly different among the three groups, nor between the scoliotic patients and normal individuals. Mental health summaries and quality of life scores were lower in Group B and C patients.

Conclusion: Patients treated for idiopathic scoliosis were found to have approximately the same quality of life as the general population. Quality of life deterioration in scoliotic patients is mainly related to psychological rather than physical factors.

Aim: We present our experience with 20 periprosthetic femoral fractures which were treated with a Biomet plate. Aim of the current study is to clarify the indications of the method and emphasize on the importance of fracture classification in the preoperative planning.

Material-methods: Retrospective study of 20 patients treated between 1999 and 2001. Ten of the patients sustained a periprosthetic fracture around a total hip replacement, 8 around a hemiarthroplasty and 2 around a revised total hip replacement.

Fractures were classified according to the Vancouver classification system. The mechanism of injury, the ambulatory status prior to the fracture and the loosening zones (according to Gruen) were studied.

Results: In 14 patients the results were satisfactory and in 3 poor. Three patients died during follow up. There were marked differences in the outcome depending on the fracture type. In B1 and C fractures the results were satisfactory. Patients with a B3 fracture had a worse outcome.

Patients with a periprosthetic fracture around a hemiarthroplasty had better results compared to those with a fracture around a total hip replacement. Poorer outcomes were noticed in patients with a periprosthetic fracture around a revised total hip replacement.

Conclusion: A careful patient selection is important for the success of the method. The accurate classification of the periprosthetic fractures helps in the preoperative planning.

Aim. To validate the implementation of relatively inexpensive and reliable laboratory tests in everyday clinical practice for the early recognition of malnutrition in patients with a hip fracture. Correlation of malnutrition with clinical parameters.

Method. Retrospective study including all elderly patients operated for a hip fracture during a five year period. Patients were evaluated according to two laboratory parameters: serum albumin and total lymphocyte count. Both parameters are established and widely used nutritional indexes. Based on the results, patients were divided into four groups: Patients in group A had both parameters within normal limits. Group B had a low total lymphocyte count and a normal albumin level. Reversibly, patients in group C had a low albumin level and a normal total lymphocyte count. In group D both values were abnormal. The groups were compared according to three clinical parameters: waiting time to operation, duration of hospital stay and one year postoperative mortality.

Results. Three hundred and twenty nine patients were included in the study. Statistically important differences were found for all three clinical parameters between malnourished patients (group D) and those with normal values (group A).

Conclusion. Serum albumin levels and a total lymphocyte count are reliable nutritional indexes in patients with a hip fracture. Their implementation in clinical practice can contribute to the early recognition and appropriate treatment of patients with a worse prognosis.