British Orthopaedic Association

AimsTo evaluate the accessibility and utility of current radiation personal protective equipment (PPE) provision and understand the experiences and radiation protection practices offered to all levels of Trauma & Orthopaedic (T&O) surgeons in the UK.MethodsAn incentivized electronic survey was sent to all UK T&O surgeons during a six-week period in 2024. Responses to 27 multiple-choice questions were collected and free-text responses analyzed by theme.ResultsA total of 677 responses from 196 UK NHS hospitals were received: 228 recepients (33%) were female, 455 (67%) were resident doctors, and 222 (33%) were consultants, representing a response rate of 38% (341/897) for trainees and 11% (222/2114) for consultants. Overall, 171 (25%) agreed they could find appropriate lead gown PPE; 80 (12%) had been given dosimeters, although few had received feedback; 173 (26%) received mandatory training, but many more (328, 48%) had sought training individually. When undertaken, it was felt useful. Symptoms attributed to ill-fitting PPE were common and more likely to be reported by females (odds ratio 2.5). In total, 372 (55%) did not feel protected by their current PPE, and 569 (84%) were concerned about the effects of ionizing radiation (IR) on their health. Thematic analysis confirmed concerns relating to PPE availability, education, and inconsistent advice and guidance across hospitals. Health concerns and poor morale were also highlighted.ConclusionEmployers must address the lack of compliance with the UK legislation, IR Regulations 2017 (IRR17), in relation to access to PPE, training, and monitoring. There is a need for standardized national guidelines and training.Cite this article: Bone Jt Open 2025;6(10):1321–1329.

Distal femur fractures are always a challenge to an orthopedic surgeon. They may be unstable and comminuted. Thin cortex, wide medullary canal, relative osteopenia and short distal segment adds to the complexity. The present study assessed the functional outcome of using locking compression plate fixation for fractures of distal end of femur in patients admitted to JMMC orthopedics department satisfying the inclusion and exclusion criteria from December 2017 to may 2019. Twenty cases were taken in this study. Serial follow up was done at 4, 8, 12, 24 weeks and functional outcome was assessed at the end of 24 weeks using NEERS criteria. 18 patients were treated with open reduction and internal fixation. 2 of the fractures were stabilized via MIPPO technique. No patients had implant failure and none of the cases were complicated by deep infection. 5 of the 20 patients had ‘Excellent’ Neers scores and 14 had ‘Good’ scores. Only one patient had ‘Fair’ score.
 Conclusion: Locking compression plate fixation is a safe procedure for supracondylar fractures of distal femur with good functional outcome. It can be done on a routine basis with a minimum risk of complications.
 Keywords: Functional Outcome, LCP, Open Reduction Internal Fixation, Prospective Study, Supracondylar Fracture.

Multiple successful strategies exist for the management of critical-sized bone defects. Depending on the location and etiology of an osseous defect, there are nuances that must be considered by the treating surgeon. The induced membrane technique and various modifications of the Ilizarov method (bone transport by distraction osteogenesis) have been the most common methods for biologic reconstruction. Despite the versatility and high union rates reported, they may not be practical for every patient. The rapid expansion of three-dimensional printing of medical devices has led to an increase in their use within orthopaedic surgery, specifically in the definitive treatment of critical bone defects. This article proposes indications and contraindications for implementation of this technology and reviews the available clinical evidence on the use of custom nonresorbable implants for the treatment of traumatic bone loss. Clinical cases are presented to illustrate the scenarios in which this approach is viable.

A presente obra demonstra como o avano tecnolgico impactou a rea de Cincias Exatas, fazendo com que os seus profissionais, presentes em inmeros setores, utilizassem os recursos disponveis como aliados no desenvolvimento de suas atividades.Dentro deste contexto, apresentamos dezoito captulos voltados ao estudo e anlise do avano da tecnologia no campo das diversas profisses por elas abarcadas,

A presente obra demonstra como o avano tecnolgico impactou a rea de Cincias Exatas, fazendo com que os seus profissionais, presentes em inmeros setores, utilizassem os recursos disponveis como aliados no desenvolvimento de suas atividades.Dentro deste contexto, apresentamos dezoito captulos voltados ao estudo e anlise do avano da tecnologia no campo das diversas profisses por elas abarcadas,

A presente obra demonstra como o avano tecnolgico impactou a rea de Cincias Exatas, fazendo com que os seus profissionais, presentes em inmeros setores, utilizassem os recursos disponveis como aliados no desenvolvimento de suas atividades.Dentro deste contexto, apresentamos dezoito captulos voltados ao estudo e anlise do avano da tecnologia no campo das diversas profisses por elas abarcadas,

To examine outcome for patients with hip fracture treated by a hemiarthroplasty (HA) but who actually met the United Kingdom, National Institute for Health and Care Excellence (NICE) criteria for receiving a total hip arthroplasty (THA). Match cohort study. Level 1, Academic Trauma Centre (UK Major Trauma Centre). Three hundred ninety-eight patients underwent either a HA or THA for a nonpathological displaced intracapsular fractured neck of the femur [OTA/AO 31 B3 (garden 3-4)], having met the NICE criteria for THA. HA versus THA. Two analyses were performed, the first comparing the outcome in a cohort of patients who either received a THA or HA but who all had met the NICE criteria to receive a THA (n = 398). The second analysis assessed the outcome of THA versus HA, in a matched cohort of patients who all met the NICE criteria for a THA (n = 44 matched pairs). All patients in the matched cohort were able to walk independently outdoors (WIOs) before injury. Mobility and functional outcome, 1 year after surgery. Of the 398 patients who met the criteria for THA, only 78 (19.6%) patients actually received a THA. Within the matched cohort, significantly more THA patients (92.9%, 39/42) maintained the ability to WIOs at 1-year compared with patients with HA (56.4%, 22/39; P = 0.001). There was no difference in mortality, reoperation, or complication rates for our matched population at 1 year. Patients who meet the NICE criteria for THA and are able to WIOs preinjury are more likely to have a higher level of independent mobility and a better functional outcome at 1-year if they receive a THA, as opposed to receiving a HA. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

H. T. Temple, Medical Director, Orthopaedic Innovations, Mercy Hospital, HCA East Florida Division, Miami, FL, USA H. T. Temple, 3659 South Miami Ave., Suite 4008, Miami, FL 33133 USA, Email: [email protected] All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. This CORR Insights® is a commentary on the article "What Proportion of Patients with Bone and Soft Tissue Tumors Contracted Coronavirus-19 and Died From Surgical Procedures During the Initial Period of the COVID-19 Pandemic? Results From the Multicenter British Orthopaedic Oncology Society Observational Study" by Rajasekaran et al. available at:10.1097/CORR.0000000000001568. The author certifies that neither he, nor any member of his immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR® or The Association of Bone and Joint Surgeons®.