The number of Achilles tendon ruptures is increasing, but the reasons for this remain unknown. The geographical variations in rupture rate might indicate the role of the urban life-style as a risk factor. One reason for the differences between the men and the women might be the different level of the sport activities, especially ball-games.

A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.

Vitamin D deficiency may be one important contributing risk factor for an osteoporotic fracture among elderly. We analyzed serum 25-hydroxyvitamin D [S-25(OH)D] status in patients with an acute hip fracture in southeastern Finland (61 degrees N). Consecutive patients with a fresh hip fracture (n=223) in two Finnish hospitals during 12 months and 15 months were registered prospectively. S-25(OH)D concentrations (nmol/l) were measured by radioimmunoassay-method. Hypovitaminosis D was defined as S-25(OH)D < 37.5 nmol/l and severe hypovitaminosis D: < 20 nmol/l. The highest threshold of S-25(OH)D in our analysis was > 74 nmol/l. The seasonal variation in S-25(OH)D concentrations was followed. Hypovitaminosis D was found in 53% of the patients. In 9% hypovitaminosis D was severe. Half (50%) of the patients living in their own homes, 55% of those in residential homes, and 61% of institutionalized elderly had hypovitaminosis D. Patients who used both vitamin D and calcium supplement had S-25(OH)D levels between 37.5 nmol/l and 74 nmol/l and > 74 nmol/l more often than non-users (Wx=3.85, p=0.0001). Most (41/61) of the patients who sustained the fracture during the late summer months had S-25(OH)D concentration > or = 37.5 nmol/l, whereas, in winter months the situation was quite the opposite (24/67) (Wx=3.42, p=0.0006). Twenty-two percent (50/223) had S-25(OH)D concentration > 50 nmol/l and four patients > 78 nmol/l. Half of the patients with a hip fracture suffered from hypovitaminosis D. The situation was worst in institutional and residential care, although there are personnel for taking care of vitamin D supplementation. In the late summer, one-third and in late winter two-thirds of the patients suffered from hypovitaminosis D. The geographical location of Finland indicates extensive efforts to increase the use of vitamin D supplements among elderly.

In 1988, 1212 patients with an acute pelvic fracture were registered in Finnish hospitals for primary treatment. The overall incidence in women was 29/10(5) and in men 20/10(5). The female to male ratio was 2.9 in patients who were over 49 years of age, while in younger age groups the ratio was 0.5. Half of the cases were pubic fractures. In half of the cases the mechanism of injury was a fall and in one quarter a traffic accident. Slightly more than half of the cases were stable and half of the cases were of moderate severity. The average length of hospital stay varied from 17 days in men to 21 days in women.

One-third of all falls resulted in an injury and every fifth injurious fall resulted in treatment outside the patient's own ward. The type of fall and the injury profile differed between men and women.