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Journal articles on the topic 'Orthopaedics and trauma'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Dırvar, Ferdi, Sevda Uzun Dırvar, Alper Köksal, Osman Çimen, Anıl Erbaş, İlhan Avni Bayhan, and Mehmet Akif Kaygusuz. "Experiences from a non-COVID hub referral orthopedic trauma hospital during the COVID-19 pandemic in Turkey." International Journal of Research in Orthopaedics 7, no. 2 (February 23, 2021): 183. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20210611.

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<p><strong>Background:</strong> During the COVID-19 pandemic period, resources should be reorganized to treat the increased burden of COVID-positive patients under the best conditions while simultaneously providing non-deferrable treatment to patients with no suspicion of COVID-19. In this study, we aimed to analyse the trauma patient profile and treatment strategies that emerged in the regional orthopaedic and traumatology hospital during the pandemic period after the implementation of “hub and spoke” organization among the orthopaedic and traumatology clinics.</p><p><strong>Methods:</strong> This cross-observational study was conducted in a training and research hospital in the field of orthopaedics and traumatology that was converted to a non-COVID referral orthopaedic trauma center during the pandemic. Gender, age, length of hospitalization, duration of trauma, place of trauma, severity of trauma, type of admission, type of anaesthesia and site of trauma were evaluated in the patients that presented between March 16 and May 16, 2020.</p><p><strong>Results:</strong> Of the orthopaedic trauma patients requiring surgery, 169 (62.6%) were men and 101 (37.4%) were women. In comparison of the data with that of the last year, significant increases were observed in the number of home traumas (241.5%), low-energy traumas (87.4%), patients referred from other institutions (328.9%), regional anaesthesia patients (124.2%) and patients with hip traumas (226.7%). The length of hospitalization decreased significantly (p<0.05).</p><p><strong>Conclusions:</strong> The creation of hub and spoke organization through the cooperation of orthopaedics and traumatology clinics in the region can reduce the burden on pandemic hospitals by isolating trauma patients requiring orthopaedic surgery who were not suspected of COVID-19 and directing them to dedicated orthopaedics and traumatology hospital.</p>

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2

Crenshaw, Andrew H. "Trauma-Orthopaedics." Current Orthopaedic Practice 25, no. 3 (2014): 197. http://dx.doi.org/10.1097/bco.0000000000000114.

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3

Eardley, W., P. Parker, and A. T. Cross. "Orthopaedics & Trauma." Journal of the Royal Army Medical Corps 153, no. 3 (September 1, 2007): 195–204. http://dx.doi.org/10.1136/jramc-153-03-15.

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4

LAURENCE, M. "Orthopaedics and trauma." Journal of Bone and Joint Surgery. British volume 79-B, no. 3 (May 1997): 512–13. http://dx.doi.org/10.1302/0301-620x.79b3.0790512e.

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5

Thompson, Simon, Dominic Simon, and Andrew L. Wallace. "Orthopaedics and trauma." Injury Extra 37, no. 12 (December 2006): 473–75. http://dx.doi.org/10.1016/j.injury.2006.06.110.

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6

Kayastha, S. R., B. Parajuli, A. Basi, and D. Shrestha. "Orthopaedic Services during Nationwide COVID-19 Lockdown: Dhulikhel Hospital, Kathmandu University Hospital Experience and Review." Kathmandu University Medical Journal 18, no. 2 (November 17, 2020): 29–35. http://dx.doi.org/10.3126/kumj.v18i2.32941.

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Background The Nepal government issued a nationwide lockdown due to COVID-19 from 24 March to 21 July 2020. This halted elective medical services in our hospital. A number of modifications in the orthopaedic practices at our department were made. Objective This article discusses the impact on orthopaedic load at the Department of Orthopaedics and Trauma, Dhulikhel Hospital, Kathmandu University Hospital during the lockdown. Method This is a longitudinal observational study done during the nation-wide lockdown including all the patients who presented to the hospital requiring orthopaedic consultation. For comparison purposes, the patient numbers from the same date in previous year (2019) were retrieved. Result We received no COVID-19 cases requiring orthopaedics consultation. A total of 1828 patients were seen in the Orthopaedic Outpatient Department, 1077 trauma patients in the Emergency Department, 216 patients were admitted and 210 orthopaedics procedures were performed at the operation theatre. There was 82.21% decrease in OPD patients and 56% less surgeries in OT compared to the same duration of last year. Conclusion There was a great reduction in the patient numbers visiting the hospital, which reflected in decreased number of admission and surgery. A greater part of our work during the lockdown was trauma.

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Janipireddy, Satish B., Zoha Arif Saeed, and Muhammad Zahid Saeed. "Role of robotics in trauma and orthopaedics." International Journal of Research in Medical Sciences 5, no. 8 (July 26, 2017): 3268. http://dx.doi.org/10.18203/2320-6012.ijrms20173522.

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There is always an ardent desire to obtain the best outcome in any surgery. To improve the quality of life of their patient is amongst the top priorities of most orthopaedic surgeons. It is a big challenge to accurately match a perfect pre-operative planning and obtain that intra operatively. Robotic technology is fast evolving in many surgical branches with orthopaedics as well, but limited with the price tag it comes with. Nevertheless, robotics is gaining momentum with some encouraging short-term results. Robotic surgery can offer significant improvement in surgical planning, accurate implant or prosthetic placement, which provide good outcomes that ultimately enhance patient safety. We review the various robotic advancements in the field of trauma and orthopaedic surgery.

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Trockels, Amaury, Aashish K. Ahluwalia, Joseph Harris, and Mathew Sewell. "Spinal clearance and management of spinal cord injury in the trauma patient." British Journal of Hospital Medicine 81, no. 9 (September 2, 2020): 1–8. http://dx.doi.org/10.12968/hmed.2020.0131.

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The British Orthopaedic Association's Standards for Trauma and Orthopaedics outline the essential clinical standards for spinal clearance and management of spinal cord injury in the acute trauma patient. From initial presentation in the hospital setting to long-term rehabilitation, the recommendations for clinical assessment, imaging, treatment priorities and the role of trauma networks are summarised.

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9

Swiontkowski, Marc F. "Outcome Measures in Orthopaedics and Orthopaedic Trauma. 2nd ed." Journal of Bone & Joint Surgery 87, no. 2 (February 2005): 481. http://dx.doi.org/10.2106/00004623-200502000-00053.

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10

Umer, Hafiz Muhammad, Hafiz Javaid Iqbal, Mark Webb, and William James Harrison. "Applying changes made during the COVID-19 pandemic to the future: trauma and orthopaedics." British Journal of Healthcare Management 27, no. 4 (April 2, 2021): 1–7. http://dx.doi.org/10.12968/bjhc.2020.0113.

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The NHS has made significant changes to practice and specialty training in trauma and orthopaedics as a result of the COVID-19 pandemic. This article looks at the positive and innovative changes along with lessons learnt, which could affect policies in a new challenging post-pandemic health service. At a national level, Public Health England, the British Orthopaedic Association and the Royal Colleges have issued a number of guidelines, which have evolved throughout the pandemic. Developing resilient rotas, virtual clinics, teleconsultations, webinar-based training and operating theatre reorganisation are just some examples of how collaborative working has led to positive changes, despite the huge challenges and hardships created by COVID-19. As we emerge from this crisis, the field of trauma and orthopaedics will need to prepare for the challenges of patient backlogs, neglected trauma and long waiting lists. A continuation of the innovative and collaborative working seen during the pandemic will be crucial to cope with the post-COVID-19 world of orthopaedics.

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11

McMaster, Bob. "Emergency orthopaedics and trauma." Accident and Emergency Nursing 4, no. 4 (October 1996): 178. http://dx.doi.org/10.1016/s0965-2302(96)90074-0.

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12

Calder, S. "Emergency orthopaedics and trauma." Current Orthopaedics 11, no. 4 (October 1997): 290–91. http://dx.doi.org/10.1016/s0268-0890(97)90017-7.

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13

Kapsner, Christopher. "Emergency orthopaedics and trauma." European Journal of Emergency Medicine 2, no. 4 (December 1995): 239–40. http://dx.doi.org/10.1097/00063110-199512000-00013.

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Kapsner, Christopher. "Emergency Orthopaedics and Trauma." European Journal of Emergency Medicine 3, no. 2 (June 1996): 131. http://dx.doi.org/10.1097/00063110-199606000-00014.

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Graham, Alastair J. "Emergency orthopaedics and trauma." Injury 27, no. 7 (September 1996): 531. http://dx.doi.org/10.1016/0020-1383(96)82848-8.

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16

Poacher, Arwel T., Hari Bhachoo, Jack Weston, Kavita Shergill, Gethin Poacher, and Joe Froud. "Undergraduate education of trauma and orthopaedic surgery in the UK." Bone & Joint Open 3, no. 7 (July 1, 2022): 549–56. http://dx.doi.org/10.1302/2633-1462.37.bjo-2022-0044.r1.

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Aims Evidence exists of a consistent decline in the value and time that medical schools place upon their undergraduate orthopaedic placements. This limited exposure to trauma and orthopaedics (T&O) during medical school will be the only experience in the speciality for the majority of doctors. This review aims to provide an overview of undergraduate orthopaedic training in the UK. Methods This review summarizes the relevant literature from the last 20 years in the UK. Articles were selected from database searches using MEDLINE, EMBASE, ERIC, Cochrane, and Web of Science. A total of 16 papers met the inclusion criteria. Results The length of exposure to T&O is declining; the mean total placement duration of two to three weeks is significantly less than the four- to six-week minimum advised by most relevant sources. The main teaching methods described in the literature included didactic lectures, bedside teaching, and small group case-based discussions. Students preferred interactive, blended learning teaching styles over didactic methods. This improvement in satisfaction was reflected in improvements in student assessment scores. However, studies failed to assess competencies in clinical skills and examinations, which is consistent with the opinions of UK foundation year doctors, approximately 40% of whom report a “poor” understanding of orthopaedics. Furthermore, the majority of UK doctors are not exposed to orthopaedics at the postgraduate level, which only serves to amplify the disparity between junior and generalist knowledge, and the standards expected by senior colleagues and professional bodies. Conclusion There is a deficit in undergraduate orthopaedic training within the UK which has only worsened in the last 20 years, leaving medical students and foundation doctors with a potentially significant lack of orthopaedic knowledge. Cite this article: Bone Jt Open 2022;3(7):549–556.

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17

Silva, Geeth, Robert U. Ashford, Clare J. Wildin, and Pramod Achan. "Evidence-based quality leadership in orthopaedics." British Journal of Hospital Medicine 83, no. 3 (March 2, 2022): 1–9. http://dx.doi.org/10.12968/hmed.2021.0617.

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There is a paucity of literature analysing the importance of leadership within trauma and orthopaedics. However, such skills are essential to make an orthopaedic surgeon proficient in their various roles. This literature review on leadership within orthopaedics enables an understanding of current issues. A narrative literature review was conducted using Pubmed, Medline and The National Centre for Biotechnology databases. The search string used to conduct the narrative literature review was (orthopaedic) and (leadership[Title]). The articles were screened by title, abstract and full text. A reference search was subsequently conducted on these papers using the same inclusion and exclusion criteria. The papers then underwent a thematic analysis to understand the issues surrounding leadership in orthopaedics. The critical themes recognised were quality improvement, training, women in leadership, inequality and traits of a leader. Through reviewing the themes in this article, a framework was developed to identify the current issues and potential avenues of advancing orthopaedic leadership. This narrative literature review has demonstrated a paucity of research in orthopaedic leadership. Further work would create a robust evidence base, outline ideal orthopaedic leadership and standardise training to create better orthopaedic leaders.

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Dhokia, RB, A. Rashid, KI Eleftheriou, and PS Ray. "Patient Data Protection: Electronic Transmission of Radiographs Between Resident Orthopaedic Juniors and Non-resident Seniors." Bulletin of the Royal College of Surgeons of England 93, no. 8 (September 1, 2011): 1–3. http://dx.doi.org/10.1308/147363511x588161.

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Orthopaedic registrars working in non-trauma centres participate in non-resident on-call rotas. These rely on a dedicated junior resident tier to provide 'first-on' cover. This responsibility is usually shared among core surgical trainees although it is increasingly being taken on by foundation year two and general practice vocational training scheme doctors with no previous experience of orthopaedics or Advanced Trauma Life Support® training.

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19

Larkin, Marilynn. "Orthopaedics, Trauma, and Sports Medicine." Lippincott's Bone and Joint Newsletter 9, no. 7 (July 2003): 74. http://dx.doi.org/10.1097/01300517-200307000-00003.

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20

PATHANIA, VP. "Textbook of Orthopaedics and Trauma." Medical Journal Armed Forces India 56, no. 4 (October 2000): 367. http://dx.doi.org/10.1016/s0377-1237(17)30247-2.

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21

Cho, Young Seok, and Syed S. Ahmed. "Biologics in trauma and orthopaedics." Orthopaedics and Trauma 34, no. 3 (June 2020): 141–45. http://dx.doi.org/10.1016/j.mporth.2020.03.007.

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22

Butt, Paul. "Picture tests — orthopaedics and trauma." Current Orthopaedics 10, no. 3 (July 1996): 208–9. http://dx.doi.org/10.1016/s0268-0890(96)90027-4.

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23

Liew, I., J. Attwood, K. Bitar, and D. Simmons. "Acronyms in trauma and orthopaedics." Bulletin of the Royal College of Surgeons of England 101, no. 4 (May 2019): 152–55. http://dx.doi.org/10.1308/rcsbull.2019.152.

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Karuppiah, Karthik, and Joydeep Sinha. "Robotics in trauma and orthopaedics." Annals of The Royal College of Surgeons of England 100, no. 6_sup (May 2018): 8–18. http://dx.doi.org/10.1308/rcsann.supp1.8.

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Martin, Ellen, Jeannette Kraft, Rochelle Wilder, and Helen Bryant. "Safeguarding children in trauma and orthopaedics." Paediatrics and Child Health 32, no. 4 (April 2022): 151–61. http://dx.doi.org/10.1016/j.paed.2022.01.006.

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26

Vickers, Roger. "Risk management in trauma and orthopaedics." International Journal of Risk and Safety in Medicine 2, no. 2-3 (1991): 107–11. http://dx.doi.org/10.3233/jrs-1991-22-305.

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Oitment, Colby, Patrick Thornley, Thorsten Jentzsch, and Mark Pahuta. "Damage Control Orthopaedics in Spinal Trauma." Journal of the American Academy of Orthopaedic Surgeons 29, no. 24 (December 15, 2021): e1291-e1302. http://dx.doi.org/10.5435/jaaos-d-21-00312.

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Goel, S. C. "Current Problems in Orthopaedics and Trauma." Indian Journal of Orthopaedics 46, no. 1 (February 2012): 116. http://dx.doi.org/10.1007/bf03545765.

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29

Day, Lorraine. "Current Operative Surgery. Orthopaedics and Trauma." Journal of Bone & Joint Surgery 68, no. 7 (September 1986): 1134. http://dx.doi.org/10.2106/00004623-198668070-00034.

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Martin, Ellen, Jeannette Kraft, Rochelle Wilder, and Helen Bryant. "Safeguarding children in trauma and orthopaedics." Orthopaedics and Trauma 34, no. 6 (December 2020): 379–89. http://dx.doi.org/10.1016/j.mporth.2020.09.008.

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Laurence, M. "Current problems in orthopaedics and trauma." Journal of Bone and Joint Surgery. British volume 93-B, no. 1 (January 2011): 141. http://dx.doi.org/10.1302/0301-620x.93b1.26422.

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Karthik, K., T. Colegate-Stone, P. Dasgupta, A. Tavakkolizadeh, and J. Sinha. "Robotic surgery in trauma and orthopaedics." Bone & Joint Journal 97-B, no. 3 (March 2015): 292–99. http://dx.doi.org/10.1302/0301-620x.97b3.35107.

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Clarke, N. M. P. "Current operative surgery: Orthopaedics and trauma." Injury 17, no. 6 (November 1986): 424. http://dx.doi.org/10.1016/0020-1383(86)90099-9.

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Sacks, Ben, Hanaa N. Mughal, Aashish Ahluwalia, Branavan Rudran, and Kishan R. Parmar. "The BOAST recommendations for care of the older or frail orthopaedic trauma patient." British Journal of Hospital Medicine 81, no. 7 (July 2, 2020): 1–8. http://dx.doi.org/10.12968/hmed.2020.0028.

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Safe and effective care for the elderly or physiologically frail patient in cases of trauma requires a multidisciplinary perioperative approach. This article expands upon the British Orthopaedic Association Standards for Trauma and Orthopaedics guidelines for the management of the older or frail orthopaedic trauma patient. Optimisation of the patient is key to a successful surgical outcome, because these patients often have significant comorbidities involving bone health, nutrition, cognitive function and cardiovascular stability. This article discusses the evidence base for tailoring the management of these patients and the importance of doing so in an ageing population. It considers the requisite preoperative procedures and investigations, guidelines for specific cases such as comatose patients or those with complex fractures, and ceiling of care discussions, and then focuses on the postoperative period, including physiotherapy, rehabilitation goals and medical management.

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Trockels, Amaury, Aashish K. Ahluwalia, and Andrew Chetwood. "Management of urological trauma associated with pelvic fractures." British Journal of Hospital Medicine 82, no. 1 (January 2, 2021): 1–9. http://dx.doi.org/10.12968/hmed.2020.0151.

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Urological trauma is frequently encountered in patients with high energy pelvic fractures and can have debilitating long-term sequelae for patients without appropriate multidisciplinary management. Anterior pelvic ring disruption causes a high incidence of bladder rupture and urethral injuries, and initial assessment requires urological tract imaging and emergent bladder drainage before subsequent surgical repair. Pelvic ring disruption requires urgent fixation and should be managed as an open fracture in the context of significant bladder and urethral injury with urinary leakage. Long-term outcomes are variable and genitourinary dysfunction is commonly reported among patients with pelvic fractures. Optimisation of patient outcomes relies heavily on collaborative management between orthopaedic and urological specialists and requires an appreciation of the anatomical intricacies of the pelvis. This article provides an overview of the British Orthopaedic Association Standards for Trauma and Orthopaedics management of urological trauma in the context of pelvic fractures.

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Laverdière, Carl, Jason Corban, Jason Khoury, Susan Mengxiao Ge, Justin Schupbach, Edward J. Harvey, Rudy Reindl, and Paul A. Martineau. "Augmented reality in orthopaedics." Bone & Joint Journal 101-B, no. 12 (December 2019): 1479–88. http://dx.doi.org/10.1302/0301-620x.101b12.bjj-2019-0315.r1.

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Aims Computer-based applications are increasingly being used by orthopaedic surgeons in their clinical practice. With the integration of technology in surgery, augmented reality (AR) may become an important tool for surgeons in the future. By superimposing a digital image on a user’s view of the physical world, this technology shows great promise in orthopaedics. The aim of this review is to investigate the current and potential uses of AR in orthopaedics. Materials and Methods A systematic review of the PubMed, MEDLINE, and Embase databases up to January 2019 using the keywords ‘orthopaedic’ OR ‘orthopedic AND augmented reality’ was performed by two independent reviewers. Results A total of 41 publications were included after screening. Applications were divided by subspecialty: spine (n = 15), trauma (n = 16), arthroplasty (n = 3), oncology (n = 3), and sports (n = 4). Out of these, 12 were clinical in nature. AR-based technologies have a wide variety of applications, including direct visualization of radiological images by overlaying them on the patient and intraoperative guidance using preoperative plans projected onto real anatomy, enabling hands-free real-time access to operating room resources, and promoting telemedicine and education. Conclusion There is an increasing interest in AR among orthopaedic surgeons. Although studies show similar or better outcomes with AR compared with traditional techniques, many challenges need to be addressed before this technology is ready for widespread use. Cite this article: Bone Joint J 2019;101-B:1479–1488

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37

Kum, Ajayar, Chanchal Kumar Dalai, and Santanu Banerjee. "Distribution of illness of orthopaedic outpatient department in a tertiary care teaching hospital in West Bengal: a cross sectional study." International Journal of Research in Medical Sciences 6, no. 1 (December 23, 2017): 206. http://dx.doi.org/10.18203/2320-6012.ijrms20175720.

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Background: Orthopaedic Outpatient Department (OPD) is an important part of health care system. Patients coming with different illness for treatment. Distribution pattern of illness represents the area from where patients come for treatment.Methods: Cross sectional, Observation Study. The patients who had willingly participated were enrolled on the basis of subject selection criteria. Prescriptions were collected from newly patients attending the Orthopaedics OPD. No follow up visit was done.Results: Male patients attended more than female gender (62% vs 38%). 18-30 years age group attended OPD much than another group (32.5%). Trauma is an important contributing factor (38.5%). History of trauma was seen more in male gender group and among 18-30 years age group. Low back pain is common problem. (29.5%).Conclusions: Low back pain is the common problem among patients attended Orthopaedic OPD. Trauma is an important contributing factor among 18-30 years age group.

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38

Myl’nikova, T. A., L. S. Shalygina, M. V. Gusev, O. I. Ivaninskiy, and I. A. Tsytsorina. "Methodic Approaches to Evaluation of Requirements in Traumatologic and Orthopaedic Care to Child Population in Novosibirsk Region." N.N. Priorov Journal of Traumatology and Orthopedics 21, no. 3 (September 15, 2014): 10–14. http://dx.doi.org/10.17816/vto20140310-14.

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High social significance of traumatism in child population (2 nd place by the level of primary morbidity and 8 th one by the causes of disability) determines the priority of traumatologic and orthopaedic service development. Great importance is given to the prognosis of justified requirement in this type of medical care for the short term prospective. Study was performed basing on the analysis of official statistic data on Novosibirsk region for 2005-2012 as well as on the results of expert evaluation of traumatologic and orthopaedic service condition, problems and prospective of development. It is stated that provision of traumatologic and orthopaedic care availability to child population in Novosibirsk region requires 19 additional beds (5 traumatologic and 14 orthopaedic). Requirement in outpatient trauma and orthopaedic surgeons makes up 32 specialists. Complex analysis of traumatologic and orthopaedic service personnel showed the presence of internal potentials for its perfection. Realization of measures on raising the qualification of trauma and orthopaedic surgeons, general surgeons and child surgeons working in the field of pediatric traumatology and orthopaedics will not require additional personnel.

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Parfitt, Tom. "Salman Yandarov: Chechen trauma and orthopaedics specialist." Lancet 369, no. 9557 (January 2007): 183. http://dx.doi.org/10.1016/s0140-6736(07)60094-4.

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40

Banaszkiewicz, Paul. "The Oxford Handbook of Orthopaedics and Trauma." Surgeon 10, no. 6 (December 2012): 369. http://dx.doi.org/10.1016/j.surge.2011.06.008.

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Eardley, W., P. Page, A. Doorgakant, and P. Parker. "Self Assessment in Trauma & Orthopaedics II." Journal of the Royal Army Medical Corps 154, no. 4 (December 1, 2008): 247–53. http://dx.doi.org/10.1136/jramc-154-04-09.

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42

Gaskin, Julian, Timothy Hardwick, Alex Vaughan, and Stephen Bendall. "Use of registries in trauma and orthopaedics." Orthopaedics and Trauma 31, no. 5 (October 2017): 335–39. http://dx.doi.org/10.1016/j.mporth.2017.07.005.

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43

Singisetti, Kiran. "Registries and databases in trauma and orthopaedics." British Journal of Hospital Medicine 70, Sup5 (May 2009): M78—M79. http://dx.doi.org/10.12968/hmed.2009.70.sup5.42249.

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44

Baitinger, V. F., O. S. Kurochkina, and I. B. Delich. "Student Years of N.N. Priorov (in commemoration of the 130th anniversary of birth)." Vestnik travmatologii i ortopedii imeni N.N. Priorova, no. 4 (December 30, 2015): 83–89. http://dx.doi.org/10.32414/0869-8678-2015-4-83-89.

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Student years of the Honoured Science Worker of RSFSR, Academician of the Academy of Medical Sciences (AMS), Soviet trauma- and orthopaedic surgeon, the founder of the Central Institute of Traumatology and Orthopaedics N.N. Priorov are presented. The atmosphere of student life with its everyday troubles, living conditions, university studies, lack of money, unemployment, revolutionary sentiments and yearning of young people for knowledge as well as the desire of teachers to share their experience to young generation is shown.

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Baitinger, V. F., O. S. Kurochkina, and I. B. Delich. "Student Years of N.N. Priorov (in commemoration of the 130th anniversary of birth)." N.N. Priorov Journal of Traumatology and Orthopedics 22, no. 4 (December 15, 2015): 83–89. http://dx.doi.org/10.17816/vto201522483-89.

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Student years of the Honoured Science Worker of RSFSR, Academician of the Academy of Medical Sciences (AMS), Soviet trauma- and orthopaedic surgeon, the founder of the Central Institute of Traumatology and Orthopaedics N.N. Priorov are presented. The atmosphere of student life with its everyday troubles, living conditions, university studies, lack of money, unemployment, revolutionary sentiments and yearning of young people for knowledge as well as the desire of teachers to share their experience to young generation is shown.

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Jayakumar, N., S. Munuswamy, R. Kulshreshtha, and S. Deshmukh. "Implant wastage in orthopaedic trauma: a UK experience." Annals of The Royal College of Surgeons of England 102, no. 3 (March 2020): 225–28. http://dx.doi.org/10.1308/rcsann.2019.0151.

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Introduction Implant wastage is an under-reported issue in orthopaedics, yet it has been shown to have a significant cost burden on healthcare budgets. In a background of a perilous financial climate in the UK health service, our aim was to define the frequency and costs of implant wastage in orthopaedic trauma. Materials and methods The trauma theatre’s implant logbook was retrospectively analysed between April 2017 and April 2018. Wasted implants were identified by the study authors independently. Patient demographics, implant details and costs were among the data collected. Product codes of wasted implants were used to identify implant costs through the manufacturer. Results Implant wastage occurred in 25.1% of trauma procedures during the study period. Most wasted implants (91%) were screws. The total cost of implant wastage was £8,377.25 during the 12-month period, accounting for 2% of the total implant budget. Wasted intramedullary nails accounted for almost 50% of the total cost. More than 51% of affected procedures involved a trainee as the primary operator. Discussion We report the first study of implant wastage in orthopaedics from the UK. Total implant wastage was higher than reported in most of the published literature, although it represented a small portion of the budget. Implant wastage is attributable to surgeons or operating theatre staff in most cases and is compounded by surgeons’ limited understanding of implant costs. Initiatives to reduce implant wastage should include raising awareness of costs and departmental wastage to surgeons and operating theatre staff as well as employing preoperative planning techniques.

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Baxter, Ian, Graeme Hancock, Matthew Clark, Matthew Hampton, Adelle Fishlock, James Widnall, Mark Flowers, and Owain Evans. "Paediatric orthopaedics in lockdown." Bone & Joint Open 1, no. 7 (July 1, 2020): 424–30. http://dx.doi.org/10.1302/2046-3758.17.bjo-2020-0086.r1.

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Aims To determine the impact of COVID-19 on orthopaediatric admissions and fracture clinics within a regional integrated care system (ICS). Methods A retrospective review was performed for all paediatric orthopaedic patients admitted across the region during the recent lockdown period (24 March 2020 to 10 May 2020) and the same period in 2019. Age, sex, mechanism, anatomical region, and treatment modality were compared, as were fracture clinic attendances within the receiving regional major trauma centre (MTC) between the two periods. Results Paediatric trauma admissions across the region fell by 33% (197 vs 132) with a proportional increase to 59% (n = 78) of admissions to the MTC during lockdown compared with 28.4% in 2019 (N = 56). There was a reduction in manipulation under anaesthetic (p = 0.015) and the use of Kirschner wires (K-wires) (p = 0.040) between the two time periods. The median time to surgery remained one day in both (2019 IQR 0 to 2; 2020 IQR 1 to 1). Supracondylar fractures were the most common reason for fracture clinic attendance (17.3%, n = 19) with a proportional increase of 108.4% vs 2019 (2019 n = 20; 2020 n = 19) (p = 0.007). While upper limb injuries and falls from play apparatus, equipment, or height remained the most common indications for admission, there was a reduction in sports injuries (p < 0.001) but an increase in lacerations (p = 0.031). Fracture clinic management changed with 67% (n = 40) of follow-up appointments via telephone and 69% (n = 65) of patients requiring cast immobilization treated with a 3M Soft Cast, enabling self-removal. The safeguarding team saw a 22% reduction in referrals (2019: n = 41, 2020: n = 32). Conclusion During this viral pandemic, the number of trauma cases decreased with a change in the mechanism of injury, median age of presentation, and an increase in referrals to the regional MTC. Adaptions in standard practice led to fewer MUA, and K-wire procedures being performed, more supracondylar fractures managed through clinic and an increase in the use of removable cast. Cite this article: Bone Joint Open 2020;1-7:424–430.

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Baxter, Ian, Graeme Hancock, Matthew Clark, Matthew Hampton, Adelle Fishlock, James Widnall, Mark Flowers, and Owain Evans. "Paediatric orthopaedics in lockdown." Bone & Joint Open 1, no. 7 (July 1, 2020): 424–30. http://dx.doi.org/10.1302/2633-1462.17.bjo-2020-0086.r1.

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Aims To determine the impact of COVID-19 on orthopaediatric admissions and fracture clinics within a regional integrated care system (ICS). Methods A retrospective review was performed for all paediatric orthopaedic patients admitted across the region during the recent lockdown period (24 March 2020 to 10 May 2020) and the same period in 2019. Age, sex, mechanism, anatomical region, and treatment modality were compared, as were fracture clinic attendances within the receiving regional major trauma centre (MTC) between the two periods. Results Paediatric trauma admissions across the region fell by 33% (197 vs 132) with a proportional increase to 59% (n = 78) of admissions to the MTC during lockdown compared with 28.4% in 2019 (N = 56). There was a reduction in manipulation under anaesthetic (p = 0.015) and the use of Kirschner wires (K-wires) (p = 0.040) between the two time periods. The median time to surgery remained one day in both (2019 IQR 0 to 2; 2020 IQR 1 to 1). Supracondylar fractures were the most common reason for fracture clinic attendance (17.3%, n = 19) with a proportional increase of 108.4% vs 2019 (2019 n = 20; 2020 n = 19) (p = 0.007). While upper limb injuries and falls from play apparatus, equipment, or height remained the most common indications for admission, there was a reduction in sports injuries (p < 0.001) but an increase in lacerations (p = 0.031). Fracture clinic management changed with 67% (n = 40) of follow-up appointments via telephone and 69% (n = 65) of patients requiring cast immobilization treated with a 3M Soft Cast, enabling self-removal. The safeguarding team saw a 22% reduction in referrals (2019: n = 41, 2020: n = 32). Conclusion During this viral pandemic, the number of trauma cases decreased with a change in the mechanism of injury, median age of presentation, and an increase in referrals to the regional MTC. Adaptions in standard practice led to fewer MUA, and K-wire procedures being performed, more supracondylar fractures managed through clinic and an increase in the use of removable cast. Cite this article: Bone Joint Open 2020;1-7:424–430.

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Caesar, B., and L. David. "Levelling the playing field: the future of the FRCS (Tr & Orth) exam." Bulletin of the Royal College of Surgeons of England 90, no. 10 (November 1, 2008): 344–45. http://dx.doi.org/10.1308/147363508x370869.

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The processes of formal assessment and examination in the UK have become increasingly convoluted over the past few years, whether at school, in higher education, or as a senior orthopaedic trainee sitting the ISB examination at fellowship level in trauma and orthopaedics. Although rationalising the ever-expanding methods of assessment inflicted upon medical students and postgraduate doctors by various government departments is not within our remit, we can endeavour to shed light on the current issues surrounding the FRCS (Tr & Orth) examination.

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Perry, D. C., J. G. Wright, S. Cooke, A. Roposch, M. S. Gaston, N. Nicolaou, and T. Theologis. "A consensus exercise identifying priorities for research into clinical effectiveness among children’s orthopaedic surgeons in the United Kingdom." Bone & Joint Journal 100-B, no. 5 (May 2018): 680–84. http://dx.doi.org/10.1302/0301-620x.100b5.bjj-2018-0051.

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Aims High-quality clinical research in children’s orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children’s orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children’s Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes’ disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children’s orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680–4.

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