Left sided hip fractures are more common but no obvious cause has been identified. Left handedness has previously been associated with an increased risk of fracture for a number of sites but to the best of our knowledge no association between handedness and hip fracture has previously been reported. 2 separate 6-month prospective reviews of hip fracture patients aged over 65 years-of-age were conducted at 2 different hospitals. Handedness was dete2rmined at the time of admission. The second review focused on the use of walking aids. Patients with a previous cerebrovascular accident, neurological condition or contralateral hip prosthesis were excluded due to increased balance problems and falls risk.Aim
Methods
Training the next generation of surgeon's forms part of routine Consultant practice. Stress causes activation of the Autonomic Nervous System and this can be directly measured using heart rate (HR). Training time is limited with pressures from EWTD and management and efficiency targets. The aim of this study was to assess whether being an orthopaedic trainer is more stressful than performing the surgery. This was a prospective multicentre study. Consultant orthopaedic surgeon HR was monitored intra-operatively using a ‘Wahoo Fitness’ chest strap and the data recorded by the proprietary Android app. Data was collected prior to surgery to obtain a resting heart rate, and at set points during total hip arthroplasty (THA) and total knee arthroplasty (TKA). The peak and mean HR for each stage of the operation were recorded and compared to cases where the consultant surgeon was performing the case or assisting a trainee. Data was compared with a 2-way ANOVA with repeated measures.Introduction
Methodology
This study was designed to assess the standard of orthopaedic training of Senior House Officers in the U.K. and to determine the optimum time that should be spent in these posts before registrar training. Two MCQ papers were constructed. One for the pre test and one for the post test. Questions covered all aspects of orthopaedics and trauma including operative surgery. The paper was firstly tested on controls including medical students, house officers, registrars of various grades and consultants. There was no statistical difference in the results for the two papers within the groups indicating that pre and post test papers were of similar standard. In addition the average scores in the tests increased proportionately to the experience and grade of the control. 129 SHOs from 25 hospitals in 10 different regions were tested by MCQ examination at the beginning of their 6-month post. They were again tested at the end of the job. The differences in score were compared. This difference was then correlated with the experience and career intention of the SHO. There was no statistical difference between pre and post test results in all groups of SHOs in the study (student t test). The best improvement in scores during this six month period were seen in SHOs of 1–1.5 years orthopaedic experience. SHOs of more than 3 years experience demonstrated the smallest improvement in their score. There was a net loss of seven trainees with a career intention of orthopaedics to other disciplines. In the vast majority of Senior House Officer posts in this country, very little seems to be learnt during a six-month attachment. This is especially so for those who are doing orthopaedics for the first time as well as very experienced SHOs.
To assess patient/parent satisfaction with treatment of radial Forearm Buckle Fractures without the necessity of fracture clinic visits. A+E staff were provided with definitions and suitable example X-Rays of radial forearm buckle fractures. The A+E staff were asked to mark the films with a green dot for Radiological review if the patient was included in the study, and these films were seen within 24 hours by a consultant radiologist. Over a three month period all patients with radial forearm buckle fractures seen in A+E were treated with an Alder Hey splint rather than plaster, they were then given a fracture clinic appointment for three weeks later. At this visit the medical staff completed a proforma with the following information, appropriateness of the diagnosis, side, bone/cortex involved, degree of angulation as well as the mode of injury. The patients and their parents were asked whether they were happy with the level of support that the splint gave and whether they would have been happy to remove the splint without visiting the fracture clinic. 72 (86.7%) had suffered low energy injuries, 5 (6%) high energy injuries, 5 (6%) did not attend their clinic appointment. 65 of 78 (83%) of parents and 65 of 72 (90%) of patients felt that the level of provided support was adequate (6 patients too young to answer) 58 of 78 (74%) of parents and 53 of 72 (74%) of patients would have been happy to make the decision to remove the splint themselves (6 patients too young to answer) 5 (6%) of the diagnoses were deemed to be inappropriate, of these 2 were picked up in radiology review and sent to clinic and 3 were soft tissue injuries. We feel that the results show that the majority of patients with radial forearm buckle fractures (appropriate guidelines available to A+E staff) do not need to be seen in the fracture clinic, as long as their X-Rays are reviewed and any inappropriately diagnosed fractures sent to clinic. This has significant implications both for fracture clinic workload and also financially for hospitals.
