Abstract
Purpose of study: To compare our practice of paediatric foot and ankle surgery with other hospitals in the UK and to assess the safety and patient satisfaction of day-case procedures on an afternoon list.
Methods and Results: A postal questionnaire was sent to 135 consultant members of BSCOS to identify which foot and ankle operations were being performed as inpatients (“Major surgery”) and day-cases (“Minor surgery”). We received 87 (64%) replies over 3 months. The survey revealed that certain procedures were being performed as a day-case in fewer than 35% of centres in the UK. These included excision of tarsal coalitions, tendon transfers, metatarsal osteotomies and open posterior releases for equinus. These same procedures are performed routinely as day-cases at Birmingham Children’s Hospital.
We focussed on a single surgeon series with a once weekly afternoon operating list. We identified 24 “major operations” on 19 patients that were performed as a day case over 21 months. The parents of each patient were contacted by telephone to complete a satisfaction survey. We demonstrate that there were no problems that should have warranted an inpatient stay.
Conclusions: Most paediatric foot and ankle surgery can be performed satisfactorily as a day case which has obvious cost implications for the NHS. Although this is an accepted practice among adults, the majority of paediatric orthopaedic units are yet to accept this protocol.
Correspondence should be addressed to BSCOS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
