Introduction: The use of an Aircast walking boot following operative fixation of ankle fractures has been shown to significantly improve early patient comfort, post-fracture swelling and time to full rehabilitation. However, the practical implications and in particular the financial impact of this orthosis has not been assessed. The current study, therefore, aims to determine whether use of the removable splint following operative fixation provides an economically viable alternative to the standard below knee cast.

Materials and methods: Between May 2006 and January 2007 those patients who underwent operative ankle fixation and who were treated postoperatively with the use of an Aircast walker were identified. A group of age-matched controls were used for comparison. Demographic details and postoperative outcomes including postoperative stay were obtained from the hospital notes and computer records.

Results: 12 patients were treated with an Aircast boot during the study period. The mean age of the study group was 43.6 years compared to 43.3 years in the control group. Operative fixation was carried out within 0.83 days and 0.92 days respectively. Patients in the Aircast group were discharged within a mean period of 2.92 days following surgery compared to 3.58 days in the control group.

Conclusions: The current study demonstrates that the use of an Aircast walker boot in the postoperative period is clinically comparable to the standard below knee cast. In particular, the orthosis also enables patients to be discharged home earlier, which has positive implications both for patient recovery and the overall cost of treatment.

To assess if paediatric patients are getting adequate gonadal protection whilst undergoing pelvic X-rays.

A retrospective study of 100 AP pelvic X-rays in 62 consecutive paediatric patients was performed. All children 16 years and under (mean = 8 years) who had an AP pelvic X-ray at our institution between 1^st April 2004 and 1^st July 2005 were included in the study. When reviewing the X-rays, the manufacturer’s guidelines for ideal shield size and position were strictly followed to assess whether adequate gonadal protection was being achieved (the lead shield must be completely covering the true pelvis in girls and the scrotum in boys). A subsequent questionnaire survey involving 20 radiographers was carried out.

In 78 cases gonadal protection was inadequate. This was unrelated to the child’s age or sex. In 72 cases shield position and in 11 cases shield size was incorrect. The survey showed that 40% of radiographers believed that the gonadal shield was either difficult to use or had a poor design. Twenty percent felt they had received inadequate training.

Gonadal shields reduce radiation exposure of the reproductive organs during pelvic X-rays. Many designs are available on the market but not all designs function adequately. Our study showed that a poor design of gonadal shield can cause unnecessary radiation exposure. We present this audit to make people aware of this poor design and recommend that a detailed market survey prior to buying such equipment and subsequent training of staff in its proper use must be carried out.