Hallux valgus (HV) deformities have been well defined in the adult population. HV appears to be more prevalent in elderly and female populations and it is postulated that women's shoe wear contributes to its progression.

This study was a pilot to quantify the prevalence of foot deformities and foot pain in an adolescent population.

Our cohort consisted of 202 school children aged 11–17 recruited from two schools in Edinburgh. Foot health data was recorded via the Manchester Scale (MHVS) and the Oxford Ankle and Foot Questionnaire (OAFQ). Photographic assessment of all participants allowed MHVS to be calculated by two orthopaedic surgeons. The photographic assessment was then repeated by the same surgeon 12 months later to allow inter and intra observer reliability to be calculated.

Results showed that the prevalence of HV in our cohort was 32.7% and there was a female preponderance 56% to 44%. Other foot measurements revealed 48.5% had HV-interphalangeus, 25.7% had a low medial longitudinal arch and 22.3% had a valgus hindfoot angle. Significantly more females (18%) than males (5%) wore shoes narrower than their feet (p=0.003). OAFQ scores revealed that foot pain was more common in those with HV deformities although not statistically significant (75% to 68%, p=0.243). The prevalence of foot pain was negatively correlated with age (r=−0.175, p=0.14).

This study suggests that there is a significant prevalence of HV and foot pain amongst female adolescents. This will need to be confirmed by a population study based on power calculation informed by this pilot.

Summary Statement

Uptake of robotically-assisted orthopaedic surgery may be limited by a perceived steep learning curve. We quantified the technological learning curve and 5 surgeries were found to bring operating times to appropriate levels. Implant positioning was as planned from the outset.

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 Audit (SHFA)¹ conducted in 2007 showed variations between hospitals in postponement rates for medical reasons. The report referred to 11 major clinical abnormalities described by McLaughlin² that were associated with poor postoperative outcomes and should be corrected before surgery.

This prospective audit took place in Monklands hospital for a duration of 6 weeks. All patients admitted to the orthopaedic firm from 14^th Oct 2012 to 26^th November 2012 with confirmed fracture neck of femur were prospectively included in the audit. A detailed review of the notes took place to identify whether delays were appropriate according to McLaughlin.

There were a total of 23 patients admitted during the audit period of which 21 were operated on and 2 patients treated conservatively. The mean age of this cohort was 82.8 (range 55–91) with a male to female ratio of 1:1.3. Sixteen cases (76%) were operated on within 48 hours of admission (11 cases – 52% within 24 hours). Five cases (24%) were delayed by more than 48 hours. Three cases (14%) were delayed due to lack of theatre time. Two patients (9.5%) were delayed due to request of ECHO for ?new murmur.

Our practice of managing hip fracture patients is similar to other units in Scotland with a deferral rate of approximately 25%. The patients who have a major clinical abnormality were appropriately investigated and treated before the surgery. Further improvement in management of the theatre time is needed as surgery is delayed for >24 hours in approximately 15% of medically fit hip fracture patients.