‘119 for 2’: the ramblings of a teacher after 23 years
Some potential orthopaedic surgeons’ lives are suspended for the ‘privilege’ of registrar training, then they deal with PTSD for the rest of their training and will never return to the hospital involved. Some follow the words of The Bard given to Henry V: ‘From this day to the ending of the world, but we in it shall be remembered. We few, we happy few, we band of brothers; For he to-day that sheds blood with me shall be my brother.’ Perhaps some will feel the motto of the Screaming Eagles when they shout ‘CURRAHEE’ (We stand alone together). However you feel about the training you are currently enduring or have had, a prominent thought often is how easy they have it today!
Emergent closed reduction of cervical facet dislocations: effect of a standardised protocol and purpose-built table on time to reduction.
From high-energy trauma such as motor vehicle accidents. These dislocations may result in both primary and secondary injury to the spinal cord and have the potential for devastating outcomes, such as partial or complete paralysis. Primary injury involves the acute mechanical damage of the original insult whereas secondary injury involves subsequent spinal cord compression and repercussions, such as ischaemia, oxidative stress and inflammation. It has been postulated that the severity of the spinal cord injury is determined by the extent of the initial destruction and the duration for which the spinal cord was compressed. Early reduction of the facet dislocation is thus critical for reducing the extent of secondary injury and optimising the likelihood of neurological recovery. This, in turn, has profound implications for the patient’s long-term prognosis.
Adolescent idiopathic scoliosis: shoulder balance and SRS-22 patient-reported outcome
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spine deformity without identifiable aetiology that affects 5.2% of children between 11 and 18 years. It is described as any curve greater than or equal to 10° in the coronal plane. Instrumented spinal fusion with pedicle screws and rods is the modern surgical technique used to correct the deformity. Shoulder balance is one of the indicators of successful scoliosis surgery and may influence patient cosmesis and satisfaction. Despite radiographic imbalance, patient perceptions may differ. This discrepancy between radiological and cosmetic shoulder balance was reported by Qiu et al. Matamalas et al. showed no correlation between clinical/radiological shoulder balance and perceived shoulder balance. The Scoliosis Research Society (SRS)-22 is the most widely used validated tool to measure patient-reported outcomes in this setting. It provides a simple, practical, disease-specific, patientbased assessment in AIS. Surgery has shown improvement in SRS-22 domains of pain, self-image, mental health, and function in a two-year follow-up. We reviewed AIS surgical outcome in terms of radiographic and patient-reported outcome measures (PROMs), assessing the relationship with shoulder balance.
The cost of convenience: initial costs to the state healthcare system of orthopaedic injuries in uninsured delivery motorcyclists in Cape Town
Traffic accidents place an enormous burden on the economy of South Africa and other developing countries. Motorcycle accidents, in particular, have been shown to have a higher rate of injury, and a higher cost of treatment, than other types of motor vehicle accidents. Orthopaedic injuries caused by motorcycle accidents are significant contributors to this burden. The demographic characteristics and injury patterns in patients involved in time-dependent delivery work on motorcycles (delivery motorcyclists) in South Africa have not yet been described in the literature. There is also a lack of accurate statistics regarding the number of motorcycle crashes in South Africa. The road traffic management corporation’s yearly report does not distinguish between vehicle types. Some data has been published by an organisation called the Motorcycle Safety Institute (MSI), which reported data from 2016–2019; however, the MSI themselves state that the data is in no way representative of total crashes and provide no methodology as to how the data was collected other than stating it is from credible sources.7 There are also significant discrepancies in the reported statistics available. The recently released report from Statistics South Africa, which reported on road transport deaths from 2007–2019, gives a figure for motorcycle user deaths in 2019 of 57; whereas the MSI report from 2019 claims that there were 127 deaths and 37 accidents involving delivery motorcycles across the country.
Patient-perceived barriers and facilitators to full weight-bearing with a lower-extremity circular external fixator: a qualitative study
This study aimed to address a critical gap in understanding the barriers and facilitators to full weight-bearing with lower-limb circular external fixators. Due to the dearth of available evidence on external fixator rehabilitation, this information may improve patient outcomes and treatment strategies. The research question was: What are the barriers and facilitators to full weight-bearing with a lower-limb circular external fixator?
Advancements in venous thromboembolism prophylaxis strategies for total hip arthroplasty: a comprehensive narrative review
Total hip arthroplasty (THA) is the gold standard surgical procedure for end-stage degenerative disease of the hip joint. The global demand and volume of patients receiving THA surgery is projected to rise considerably due to increasing demands for improved mobility and quality of life (QoL) among the ageing population. Current trends predict that the number of THAs performed annually in the United States of America (USA) will increase to 4 million by the year 2030, while in Organisation for Economic Co-operation and Development (OECD) countries, the number of THAs performed is projected to rise from 1.8 to 2.8 million per year between 2015 and 2050.