Aims. National hip fracture registries
Aims. The aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care. Methods. We compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national
Aims. Most patients with advanced malignancy suffer bone metastases, which pose a significant challenge to orthopaedic services and burden to the health economy. This study aimed to assess adherence to the British Orthopaedic Oncology Society (BOOS)/British Orthopaedic Association (BOA) guidelines on patients with metastatic bone disease (MBD) in the UK. Methods. A prospective, multicentre, national collaborative
Aims. Hand trauma, consisting of injuries to both the hand and the wrist, are a common injury seen worldwide. The global age-standardized incidence of hand trauma exceeds 179 per 100,000. Hand trauma may require surgical management and therefore result in significant costs to both healthcare systems and society. Surgical site infections (SSIs) are common following all surgical interventions, and within hand surgery the risk of SSI is at least 5%. SSI following hand trauma surgery results in significant costs to healthcare systems with estimations of over £450 per patient. The World Health Organization (WHO) have produced international guidelines to help prevent SSIs. However, it is unclear what variability exists in the adherence to these guidelines within hand trauma. The aim is to assess compliance to the WHO global guidelines in prevention of SSI in hand trauma. Methods. This will be an international, multicentre
Aims. Current levels of hip fracture morbidity contribute greatly to the overall burden on health and social care services. Given the anticipated ageing of the population over the coming decade, there is potential for this burden to increase further, although the exact scale of impact has not been identified in contemporary literature. We therefore set out to predict the future incidence of hip fracture and help inform appropriate service provision to maintain an adequate standard of care. Methods. Historical data from the Scottish Hip Fracture
Aims. The primary objective was to determine the incidence of COVID-19 infection and 30-day mortality in patients undergoing foot and ankle surgery during the global pandemic. Secondary objectives were to determine if there was a change in infection and complication profile with changes introduced in practice. Methods. This UK-based multicentre retrospective national
Background. BANDAIDE aka Back and Neck Discomfort relief with Altered behaviour, Intelligent Postures, Dynamic movement and Exercises (ISBN - 0995676933) is a concise self-help booklet containing strengthening exercises and illustrated information to enable patients self-manage their back and neck pain. The aim of this preliminary
Aims. The purpose of this study was to determine the weightbearing practice of operatively managed fragility fractures in the setting of publically funded health services in the UK and Ireland. Methods. The Fragility Fracture Postoperative Mobilisation (FFPOM) multicentre
The National Hip Fracture Database (NHFD) is a clinically led web based
Introduction. VTE is a possible complication of foot and ankle surgery, however there is an absence of agreement on contributing risk factors in the development of VTE. The primary outcome of this study was to analyse the 90-day incidence of symptomatic VTE following foot and ankle surgery and to determine which factors may increase the risk of VTE. Methods. This was a national, multi-centre prospective
Objectives. The primary aim was to determine the differences in COVID-19 infection rate and 30 day mortality in patients undergoing foot and ankle surgery between different treatment pathways over the two phases of the UK-FALCON
In 2007, the National Hip Fracture Database (NHFD) was conceived in the United Kingdom (UK) as a national
To evaluate the performance of this institution in its delivery of care to elderly patients with a hip fracture over an 11-year period and to establish recommendations to improve practice. Regular prospective
Objective. Guidelines published by the British Association of Spine Surgeons (BASS) and Society of British Neurological Surgeons (SBNS) recommend urgent MRI imaging and intervention in individuals suspected of having CES. The need for an evidence based protocol is driven by a lack of 24/7 MRI services and centralisation of neurosurgery to tertiary centres, compounded by CES's significant medico-legal implications. We conducted an
Objectives. The primary objective was to determine the incidence of COVID-19 infection and 30-day mortality in patients undergoing foot and ankle surgery during the global pandemic. Secondary objectives were to determine if there was a change in infection and complication profile with changes introduced in practice. Design. Multicentre retrospective national
Distal radius fractures (DRF) are very common injuries. National recommendations (British Orthopaedic Association, National Institute for Health and Care Excellence (NICE)) exist in the UK to guide the management of these injuries. These guidelines provide recommendations about several aspects of care including which type of injuries to treat non-operatively and surgically, timing of surgery and routine follow-up. In particular, current recommendations include considering immobilizing patients for 4 weeks in plaster for those managed conservatively, and operating on fractures within 72 hours for intra-articular injuries and 7 days for extra-articular fractures. With increased demands for services and an ageing population, prompt surgery for those presenting with distal radius fractures is not always possible. A key factor is the need for prompt surgery for hip fracture patients. This study is an
There is high morbidity and mortality associated with infection following orthopaedic procedures. In accordance to local guidelines, most hospitals follow a set protocol for surgical prophylaxis, which expects a compliance rate of 100%. A new protocol was introduced to the orthopaedic department of a teaching hospital in August 2013, changing from a cephalosporin, with potential C. difficile risk, to teicoplanin and gentamicin, within 30 minutes of incision. Our aim was to
Abstract. Background. University Hospital of Wales (UHW) went live as a Major Trauma Centre (MTC) on the 14th September 2020. New guidelines have been set up by the Wales Trauma Network. Aim. Prospective
Background. Cauda equina syndrome (CES) is a spinal condition requiring emergency spinal surgery once diagnosed. The patient-reported symptoms are often subtle and none have been shown to be sensitive or specific in confirming CES. Magnetic resonance image (MRI) is the diagnostic gold standard, and guidelines recommend MRI access within 24-hours of symptom presentation. Limited sequence MRI scans (sagittal T2 sequences of the whole spine) have been shown to successfully identify patients with scan-positive CES despite reducing the duration of an MRI. The aim of this
Introduction: Ankle diastasis injury occurs in up to 20% of ankle fractures. Various techniques have been used to treat syndesmosis injuries, but controversy remains and outcome is variable. In light of some recent cases of substandard syndesmosis fixations requiring revision, an
The ankle radiograph is a commonly requested investigation as the ankle joint is commonly injured. Each radiograph exposes 0.01 mSv of radiation to the patient that is equivalent to 1.5 days of natural background radiation [1]. The aim of the clinical
The Scottish Hip Fracture
Virtual Fracture Clinic (VFC) is a consultant-led orthopaedic trauma outpatient triage and management service. The use of VFC has recently become commonplace in the United Kingdom. It allows multiple referral sources to the orthopaedic team, with clinical information and imaging reviewed by a consultant in VFC who formulates an appropriate management plan with the patient contacted; either to attend clinic for consultation or discharged with advice over the phone. The VFC is more efficient than a traditionally delivered outpatient fracture clinic service. We have utilized VFC for 1 year at our hospital, East Kent University Hospital Foundation Trust (EKHUFT), and undertook a closed loop
There has been extensive research into neck of femur fractures in the elderly. Fragility non-hip femoral fractures share many of the same challenges [1]. Surgical management is complex, patients are frail and mortality rates have been reported as high as 38% [2]. Despite this, relatively little data is available evaluating the level of MDT care provided to non-hip femoral fractures. This
Clinical governance encompasses
All multidisciplinary
Prophylactic pinning of the contralateral hip in unilateral Slipped Upper Femoral Epiphysis (SUFE) persists as a source of debate with the majority of surgeons selecting this option in a proportion of patients whom they regard as at increased risk of a subsequent slip. Universal prophylactic pinning was introduced in our region in 2005 after an
Introduction We performed an
Background. National hip fracture programmes are becoming widespread, but this practice is nascent and varied. The Scottish Hip Fracture
Few doctors answer their bleep by stating who they are. Answering the phone in a formal manner is of utmost importance in the hospital setting especially by on-call teams who are normally referred patients by other specialties, general practitioners and in some cases by other hospitals. An
The primary aim was to determine the influence of COVID-19 on 30-day mortality following hip fracture. Secondary aims were to determine predictors of COVID-19 status on presentation and later in the admission; the rate of hospital acquired COVID-19; and the predictive value of negative swabs on admission. A nationwide multicentre retrospective cohort study was conducted of all patients presenting with a hip fracture to 17 Scottish centres in March and April 2020. Demographics, presentation blood tests, COVID-19 status, Nottingham Hip Fracture Score, management, length of stay, and 30-day mortality were recorded.Aims
Methods
Aims. Supracondylar fractures are the most frequently occurring paediatric
fractures about the elbow and may be associated with a neurovascular
injury. The British Orthopaedic Association Standards for Trauma
11 (BOAST 11) guidelines describe best practice for supracondylar
fracture management. This study aimed to assess whether emergency
departments in the United Kingdom adhere to BOAST 11 standard 1:
a documented assessment, performed on presentation, must include
the status of the radial pulse, digital capillary refill time, and
the individual function of the radial, median (including the anterior
interosseous), and ulnar nerves. . Materials and Methods. Stage 1: We conducted a multicentre, retrospective
Background. Both surgeon and hospital volume influence patient outcomes following revision knee arthroplasty. Purpose. To
Introduction: The role of prophylactic antibiotics in reducing the incidence of infection following hip and knee arthroplasty is well established. The British Orthopaedic Association (BOA) published best practice guidance on the use of prophylactic antibiotics in hip and knee arthroplasty. The guidance stated that all patients should receive prophylactic antibiotics at induction of anaesthesia and that each unit should have a locally agreed policy with advice from microbiologist. The aim of this
Literature suggests that joint orthopaedic and geriatric care, and geriatric orthopaedic rehabilitation units, would provide best care for fractured neck of femur (NOF) patients. These are often elderly frail patients with concurrent illnesses and co-morbidities who also have a fracture. There is to date no quantitative data. This completed
Introduction: The use of allogeneic blood is associated with many complications. A baseline
More than half of patients with neck of femur (NOF) fractures report their pain as severe to very severe in the first 24hrs. Opioids remain the most commonly used analgesia and are effective for static pain but not dynamic pain. Opioids provide suboptimal analgesia when patients are in a dynamic transition state and their side-effects are a source of morbidity in these patients. The Fascia Iliaca Compartment Block (FICB) involves infiltration of the fascia iliaca compartment with a large volume of low concentrated local anaesthetic to reduce pain by affecting the femoral and lateral cutaneous nerve of the thigh. The London Quality Standards for Fractured neck of femur services (2013) stated that the FICB should be routinely offered to patients. We performed an
Parker et al examined the effect that delay to surgery has on patients with proximal femoral fractures. They found that a delay of more than 48 hours to surgery significantly increased the patient’s length of stay. They examined delays due to lack of theatre resource only. Therefore an
Background. The approach to Intramedullary (IM) fixation of long bone fractures remains a controversial issue. Early reports demonstrated less favourable results of retrograde nailing as compared with antegrade options due to higher non-union rates. The aim of this
Aim. The knee radiograph is a commonly requested investigation as the knee joint is commonly injured. Each radiograph exposes 0.01mSv of radiation to the patient that is equivalent to 1.5 days of natural background radiation. Also, each knee radiograph costs approximately £37.16 to produce. The aim of the clinical
The results are reported of an
Appropriate surgical management of hip fractures has major clinical and economic consequences. Recently IMN use has increased compared to SHS constructs, despite no clear evidence demonstrating superiority of outcome. We therefore set out to provide further evidence about the clinical and economic implications of implant choice when considering hip fracture fixation strategies. A retrospective cohort study using Scottish hip fracture
Background. Best practice tariff (BPT) for hip fracture was introduced in April 2010, offering financial incentive to encourage trusts to implement best practice and improve quality of care. This equates to £1335. An early indicator of a patient's outcome is the time to operation from admission, with best practice targets of <36hours as a key marker of quality. As well as being detrimental to patient experience, delays in the time to operation have clear links to increased mortality rates. Method. We performed a retrospective
Purpose of the study and background. This
Introduction: Sliding screws has been described to use in hip fractures since 1950s. Failure of fixation varies from 16 – 23%. We aim to assess the effect of
Aim: To assess satisfaction of patients seen in the fracture clinic in our DGH. The results from the
The European Working Time Directive is a directive from the Council of Europe to protect the health and safety of workers in the European Union. The working time directive currently ensures a 56 working hour week and by August 2009 a 48 hour maximum working week. To accommodate such a reduction in working hours, the on call rotas for institutions have had to change. Has this had an affect on trauma exposure for current specialist registrars?. Materials and Methods: Data collection was from electronic logbooks of orthopaedic specialist registrars and locum appointment trainees on the Southwest Thames rotation. From the elogbooks indexed trauma procedures were
Hallux rigidus was first described by Davies-Colley and Cotterill in 1887 and varied management techniques have been described by authors since. This paper carries out an
Introduction. Flexor tendon injuries are quite common injuries. They can result in persisting functional deficit if not repaired and appropriately rehabilitated. We look at flexor tendon injuries over a period of 1 year and re-audited three years later. Method. We
Aim. NICE guidance on lumbar total disc replacement (TDR) recommends ongoing
Day case surgery is commonplace in the field of orthopaedic surgery, being suitable for a wide range of both trauma &
elective procedures. It became apparent within our unit that an unacceptably high number of cases were being cancelled for a variety of reasons. We set out to identify these reasons and thereby develop a simple screening process to reduce the number of cancellations. Initial
In recent years there has been growing interest in enhanced recovery regimes in lower limb arthroplasty due to potential clinical benefits of early mobilisation along with cost-savings. Following adoption of this regime in a district general hospital, it was observed that traditional dressings were a potential barrier to its success with ongoing wound problems in patients otherwise fit for discharge. The aim of this
Diagnosis of complex regional pain syndrome (CRPS) can be challenging. We explore the role of fracture clinic in diagnosis and management with a closed-loop
We present a complete
Aim and objectives of the study: To assess the true incidence and reasons for readmission after fracture neck of femur treatment and its effect on Trust star rating. Introduction: Star ratings (zero to three) show how well a Trust is performing and is awarded against a set of performance indicators (Patient Focus, Capacity and Capability Focus and Clinical Focus) as laid by CHAI. These indicators cover the standards and outcomes of treatment given. CHAI reports 9% readmission as an emergency within 28 days, and assumes that a proportion of the observed readmissions are potentially avoidable. Materials and Methods: An
Aim: To assess the impact of a proforma pathway on the care of patients following fractured neck of femur at Maidstone General Hospital compared to the gold standard set out in the British Orthopaedic Association and British Geriatric Society Blue Book – The Care of Patients with a Fragility Fracture. Objectives: Initial
Hip fracture is a common and serious injury affecting the elderly. Many patients have co-morbidities which may need to be investigated and treated before surgery but, conversely, delay in surgical management of these patients leads to increased morbidity and mortality. The Scottish Hip Fracture
The Scottish Hip Fracture
Aim: To reduce the amount of blood wastage in our unit. Method: In 72 patients, the number of blood units cross-matched and the haemoglobin/haematocrit fall were
An independent
Hip fractures have increased in most western countries during the end of the last century. This increase will continue mainly because of an increasing number of elderly persons and also due to an increase in the risk of hip fractures in the oldest. This constitutes a threat to resources for medical care. Practise differs concerning choice of operation method and principles for rehabilitation throughout the world. A national registration of the outcome after hip fractures in the elderly started in 1988 in Sweden to compare different methods of surgery, mobilization and rehabilitation. This project has attracted great international interest and several centres have participated with prospective registration. With support from the European Commission a project was started in 1995 called Standardised
Purpose and Background: The introduction of clinical governance made NHS organisations accountable for the monitoring and continuous improvement of the quality of patient care at all levels, across all services. Implementation of evidence-based practice and provision of an adequate infrastructure to support it is a major component and at local level, clinicians in all NHS organisations are required to participate fully in
Purpose: An
Purpose of the study: To
Background: Osteoporosis is a significant cause of morbidity and disability through an increase in bone fragility and susceptibility to fracture. In March 2001 guidelines were produced by The Clinical Resource Efficiency Support Team (CREST) on the Prevention and Treatment of Osteoporosis, which were distributed throughout the primary and secondary care groups. Aim: The aim of this
Intramedullary nails are a well accepted method of fixing fractures of the femur, however there are several potential complications associated with femoral nail insertion. One under-reported complication is perforation of the anterior cortex of the distal femur. Cortical perforation is well documented in immature bone however there is little evidence of perforation in skeletally mature adults. We present a 5 year retrospective clinical
Introduction: Seeding of bone or soft tissue tumour along the biopsy tract is a known complication of percutaneous biopsies. Correct surgical management requires preoperative Identification and excision of the biopsy tract at time of surgery. We aim to
The administration of prophylactic antibiotics is essential in the prevention of surgical site infection, particularly when metalwork is implanted. Intravenous Cefuroxime has been the antibiotic of choice for prophylaxis in our unit over the last few years. Unfortunately this has been linked to an increased rate of Clostridium Difficile infection. Our departmental antibiotic prophylaxis guidelines, based on the Scottish Intercollegiate Guidelines Network (SIGN), were therefore revised, such that intravenous Flucloxacillin and Gentamicin became the first line agents. We primarily aimed to assess whether prophylactic antibiotics were being administered according to our revised local guidelines. Steps were then taken to improve adherence to the guidelines, and the
Virtual fracture clinics (VFC's) aim to reduce the number of outpatient appointments while improving the clinical effectiveness and patients experience through standardisation of treatment pathways. With 4.6% of ED admissions due to trauma the VFC prevents unnecessary face to face appointments providing a cost savings benefit to the NHS. This project demonstrates the importance of efficient VFC process in reducing the burden on the fracture clinics. We completed preformed a retrospective cross-sectional study, analysing two cycles in May (n=305) and September (n=332) 2021. We reviewed all VFC referrals during this time assessing the quality of the referral, if they went on to require a face to face follow up and who the referring health care professional was. Following the cycle in May we provided ongoing education to A&E staff before re-auditing in September.Introduction
Methods
Patients with hip fracture are at high risk of venous thromboembolism (VTE). Chemical thromboprophylaxis with low molecular weight heparin (LMWH) is associated with a risk of major bleeding in certain patient groups, such as those with renal failure. In these patients, unfractionated heparin should be used. Our aim was to determine the practice of VTE risk assessment in patients admitted with hip fracture against the national guidance, which states that all should have VTE risk assessment on admission. We also assessed the impact of introducing the VTE risk assessment form on prescribing practice of chemical thromboprophylaxis in patients with renal failure. Prospective
In January 2000 we introduced identical guidelines for the more rapid rehabilitation of Achilles tendon ruptures, whether treated operatively or non-operatively. A relaxed equinus cast was used to four weeks, then a CAM walker to eight weeks with supervised mobilisation. The aims of this study were to compare the outcomes of the operative and non-operative groups treated with the same rehabilitation program and
Introduction: Practice guidelines recommend functional restoration as a cardinal intervention for chronic low back pain. Published studies attest variously to either modest or good efficacy for functional restoration programs. However, although published data might set a benchmark of what outcomes can be achieved in research studies, they do not necessarily indicate what is actually achieved in conventional practice. Methods: A prospective
Paediatric wrist fractures are routinely managed with closed reduction and a molded cast. Gap(GI) and Cast indices(CI) are useful in predicting re-displacement following application of cast. Over 6 months we
Blood is a costly commodity with side-effects that can be avoided by eliminating unnecessary transfusion. The purpose of this study was to prospectively
Introduction. We conducted an
Background. The Targon FN plate is a combination of the sliding hip screw and multiple cancellous screws. It is used in the fixation of intracapsular fractures of the neck of femur. The aim of this prospective
Background and Aims:. In 2009 a combined clinic was formed by the orthopaedic Surgeons and Developmental Paediatricians in our hospital. The aim was to help improve the assessment and management of patients with Cerebral Palsy. Included in the assessment team, are the paediatric orthopaedic surgeons, the developmental paediatricians, physiotherapists and occupational therapists. Our aim was to
This paper will focus on the use and including a demonstration of Digital photography for the purpose of clinical documentation,
An
We present a complete
The use of intramedullary lengthening devices is becoming increasingly popular. There are no published data regarding the incidence of venous thromboembolism following intramedullary lengthening and no reports or guidance for current practices on use of thromboprophylaxis. Following a case of post-operative deep vein thrombosis in our institution, we felt that it is important to assess best practice. We conducted this survey to collect data that would describe current practice and help guide consensus for treatment. We have identified surgeons across the UK that perform intramedullary lengthening through the British Limb Reconstruction Society membership and a Precise Users database. Surgeons were contacted and asked to respond to an online survey (SurveyMonkey - SVMK Inc.). Responses to thromboprophylaxis regimes employed in their practice and cases of venous thromboembolism were collated.Introduction
Materials and Methods
Introduction. ‘VTE disease is the new MRSA’, with much attention received in the media and the political world. Following the 2010 NICE guidelines all patients admitted to hospital should have VTE prophylaxis considered and a formal VTE risk assessment done with documentation and review in a 24 hour period. We carried out a completed
Aim: To identify the incidence of regular medication not being prescribed on initial admission of emergency surgical cases. Material and Method: The data for this
Cognitive impairment is common in patients with hip fracture both on admission and may develop later on. Reduced cognitive function is a risk factor for development of delirium, correlates with poor rehabilitation, and is an independent predictor of increased mortality. Despite its commonplace and potential for serious morbidity, cognitive dysfunction is often poorly assessed & diagnosed. Our aims were to 1) assess the practice of cognitive assessment on admission for hip fracture patients according to local guidelines and 2) ascertain whether it can be improved by the formal introduction of Abbreviated Mental Test Score (AMTS) & Clock Drawing Test (CDT) in the hip fracture admission proforma. A prospective
Introduction. Ottawa ankle rules originally described in 1992 have been shown to improve the pick-up rates of ankle fractures and avoid the need for unnecessary X-rays, thus minimising cost and radiation to the patient. We decided to carry out an
Aim: To
Transferring patient data to the care of the oncoming team is the point at which the patient is most vulnerable on their journey through the healthcare system. Effective handover is vital to protect patient safety and has become increasingly more important after introduction of shift patterns for junior doctors following the implementation of the European Working Time Directive. The aim was to assess whether the introduction of a standardised proforma and traffic light system, would improve weekend handover of patients in our orthopaedic unit. Data was collected in the form of hand written data, for 3 months, in our department. This was analysed and a standardised handover sheet and traffic light system to highlight patient priority was introduced. Following a 1 week trial, the proformas were reviewed following feedback from colleagues. A re-audit was commenced and data collected for a further 2 months. There were 108 patients handed over on weekends during the re-audit compared to the 126 in the initial
The 1995
To evaluate the patient experience of patients referred to the ESP Orthopaedic Triage Service. To identify the demographic data of the patients. To evaluate patients' expectations and satisfaction of the service. A prospective
Purpose. Tarsal Tunnel Syndrome (TTS) was first reported by Keck and Lam separately in 1962. It has been regarded as the lower limb equivalent to Carpal Tunnel Syndrome (CTS). The gold standard of diagnosis proposed over the years is nerve conduction study (NCS). In reality, TTS is much harder to diagnose and treat compared to CTS. Signs and symptoms can be mimicked by other foot and ankle conditions. Our unit had not seen a single positive nerve conduction result of TTS in clinically suspicious cases. We have therefore
Presenters Position:. Purpose of Study:. To perform a retrospective
Fractures of the neck of femur are common in the older adult with significant morbidity and mortality rates. This patient cohort is associated with frailty and multiple complex medical and social needs requiring a multidisciplinary team to provide optimal care. The aim of this study was to assess the outcomes at 5 years following implementation of a collaborative service between the Orthopaedic and Geriatric departments of Southland Hospital in 2012. Retrospective data was collected for patients aged 65 years and older who were admitted with a fragility hip fracture. Data was collated for 2011 (pre-implementation) and 2017 (post-implementation). Demographics and ASA scores were recorded. We assessed 30-day and 1-year mortality, surgical data, length of stay and complications. There were 74 patient admissions in 2011 and 107 in 2017. Mean age at surgery was 84.2 years in 2011 and 82.6 years in 2017 (p>0.05). Between the 2011 and 2017 groups there has been a non-significant reduction in length of stay on the orthopaedic ward (9.8 days vs 7.5 days, p=0.138) but a significant reduction in length of stay on the rehabilitation ward (19.9 vs 9 days, p<0.001). There was a significant decrease in frequency of patients with a complication (71.6% vs 57%, p=0.045) and a marginal reduction in number of complications (p=0.057). Through logistic regression controlling for age, sex and ASA score, there was a reduction in the odds of having a complication by 12% between 2011 and 2017 (p<0.001). There was no difference in mortality between the groups. The orthogeriatric model of care at Southland Hospital appears to have reduced both the frequency of complications and length of stay on the rehabilitation ward 5 years after its implementation. This is the first study in New Zealand demonstrating medium-term post-implementation follow-up of what is currently a nationally accepted standard model of care.
Aims: Secondary prevention in patients suffering neck of femur fractures is an effective but under utilised strategy in reducing subsequent fragility fractures. Published BOA guidelines recommend patients aged 75 or over with fragility fractures should receive bisphosphonates, falls risk assessment, and vitamin D supplements if there are concerns regarding deficiency. This
BACKGROUND: With the improvement of the ultrasound technology, there has been an increasing ability to image the soft tissues of the hand and wrist. This means structures such as tendon, ligaments and soft tissues can be visualized both statically and dynamically. AIM: The aim of our study was to
Approximately 20% of patients with ankle fracture sustain syndesmosis injury. This is most common in trans-syndesmotic (type B) and supra-syndesmotic (type C) fibula fractures. Intra-operative assessment of syndesmosis integrity is important because failure to treat these injuries can result in ankle instability and pain. Our aim was to
Health care facilities are major contributors of waste to landfills, with operating rooms estimated to assume 20–70% of this waste. With hip arthroscopy for femoroacetabular impingement (FAI) on the rise, it is important to understand its environmental impact and identify areas for greening practices. Given its minimally-invasive nature, we hypothesise overall arthroscopic waste per FAI patient case to be approximately 5 kg, with minimal biohazard waste. The purpose of this study was to determine the amount of waste produced in FAI procedures and understand the environmental impact of the procedure to aid us in developing greening practices. A single surgeon waste
Implementation of the World Health Organisation checklists have reduced errors, however, the impact of pre-operative briefings on adverse events has not been assessed. A prospective case control study assessing the association between pre-operative briefings and minor, potentially major and major adverse events was performed in two phases. Phase one involved prospective data collection for trauma and orthopaedic lists over 2 weeks. Changes were implemented and following this, the study was repeated (phase two). 41 lists were