The purpose of this study was (1) to evaluate the adequacy of informed consent documentation in the trauma setting for distal radius fracture surgery compared with the elective setting for total knee arthroplasty (TKA) at a large public hospital and (2) to explore the relevant guidelines in New Zealand relating to consent documentation. Consecutive adult patients (≥16 years) undergoing operations for distal radius fractures and elective TKA over a 12-month period in a single-centre were retrospectively identified. All medical records were reviewed for the risks and complications recorded. The consent form was analysed using the Flesch Reading Ease Score (FRES) and the Simple Measure of Gobbledygook (SMOG) index readability scores. A total of 133 patients undergoing 134 operations for 135 distal radius fractures and 239 patients undergoing 247 TKA were included. Specific risks of surgery were recorded significantly less frequently for distal radius fractures than TKA (43.3% versus 78.5%, P < 0.001). Significantly fewer risks were recorded in the trauma setting compared to the elective (2.35 ± 2.98 versus 4.95 ± 3.33, P < 0.001). The readability of the consent form was 40.5 using the FRES and 10.9 using the SMOG index, indicating a university undergraduate level of reading. This study has shown poor compliance in documenting risks of surgery during the informed consent process in an acute trauma setting compared to elective arthroplasty. Institutions must prioritise improving documentation of informed consent for orthopaedic trauma patients to ensure a patient-centred approach to healthcare

With modern day easy access to information, many health staff may be presumptuous of patients' level of understanding of medical terms and abbreviations. A recent audit of consent forms in Orthopaedic trauma in our department showed that doctors used abbreviations in 21% of consent forms; this was seen to increase to 48% during the re-audit. The findings motivated us to conduct this study to evaluate the level of patients' understanding of commonly used abbreviations/terminologies. This questionnaire-based study recruited patients from both our elective and Trauma Orthopaedic units. Patient age, gender, medical and educational backgrounds were all randomised. Patients' understanding of 24 abbreviations/terminologies, selected from consent forms, patients' discharge letters and verbal communication with patients, were quantitatively and qualitatively assessed. Patients' perspectives were also sought. All 182 patients who participated were proficient in English language. Most patients(80.2%) understood the term “physio,” however only 3.8% could correctly interpret “DHS”. 10% of patients understood “TKR,” 8.2% understood “THR” and 3.8% understood “NOF”. Interestingly, although 61.5% understood “DVT,” only 8.2% understood “PE” with most interpreting it as physical education/exercise. Only 8.2% related “MI” to any form of cardiac pathology. Almost all patients confirmed the use of unfamiliar abbreviations by health staff during communication. Our study revealed that patients were not conversant with many abbreviations used in Orthopaedics. There is a need for greater awareness amongst doctors and other health staff about the indiscriminate use of abbreviations. From patients' perspective, interpretation should be given when using abbreviations or avoid their use altogether