Update on radiation protection of the thyroid gland.

In recent years, concern about the effects of ionizing radiation on exposed individuals has led to the need to regulate and quantify the use of diagnostic and therapeutic techniques. Geopolitical events in recent times have also increased the population's perception of insecurity regarding ionizing radiation, and we increasingly face patients reluctant to undergo certain types of scans in our nuclear medicine services and, albeit less frequently, in radiology services. This article aims to summarise the extent to which ionizing radiation is present in our daily lives and how diagnostic and therapeutic procedures can affect our health, particularly from the perspective of their effects on the thyroid gland, one of the body's most radiation-sensitive organs.

The effect of COVID-19 on a Major Trauma Network. An analysis of mechanism of injury pattern, referral load and operative case-mix.

Purpose: The aim of this study was to evaluate changes in both mechanism and diagnoses of injuries presenting to the orthopaedic department during this lockdown period, as well as to observe any changes in operative case-mix during this time.

Methods: A study period of twelve weeks following the introduction of the nationwide "lockdown period", March 23 - June 14, 2020 was identified and compared to the same time period in 2019 as a "baseline period". A retrospective analysis of all emergency orthopaedic referrals and surgical procedures performed during these time frames was undertaken.

Lateral Clavicle Fracture Fixation Using a Superiorly Placed Locking Plate.

Clavicle fractures are common injuries that account for 4% of all fractures, and approximately 21% of clavicle fractures are lateral. Studies have demonstrated that displaced lateral clavicle fractures with disruption of the coracoclavicular ligaments have nonunion rates as high as 28%. Many surgical techniques for fixation of lateral-end clavicle fractures have been proposed.

Bilateral Primary Repair of Simultaneous Bilateral Distal Biceps Rupture.

A case of simultaneous bilateral distal biceps tendon rupture in a recreational gymnast is presented. Achieving bilateral acute primary repair can be challenging as any immobilization will lead to disability and difficulty with self-care and activities of daily living. We have reviewed the evidence of this rare condition and demonstrate that modern rehabilitation techniques, which allow early mobilization, can make simultaneous bilateral primary repair a viable option in such cases.

Neoadjuvant Chemoradiotherapy Treatment for a Classic Biphasic Pulmonary Blastoma with High PD-L1 Expression.

Pulmonary blastomas are rare malignant tumors, comprising only 0.25-0.5% of all malignant lung neoplasms.

Surgical skills simulation in trauma and orthopaedic training.

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience.

Surgical waiting times and patient choice: how much delay do patients really want?

Background: The 18-week target to treatment government initiative was implemented in 2004. In order for this to work, patients need to accept operative dates provided, otherwise the pathway will fail.

Aim: The aim of this prospective study was to identify the earliest time patients would accept surgical intervention following assessment at an outpatient clinic and to identify the reasons why some patients would choose to delay surgery.

Long-term survival of proximal humerus allografts for reconstruction following resection of malignant bone tumours.

We previously reported early favourable results concerning allograft use in proximal humerus reconstruction following malignancy. We now present the long-term follow-up of patients who underwent tumour resection with massive humeral allograft reconstruction. This is a retrospective review of 8 consecutive patients who underwent massive proximal humeral allograft for primary or secondary bone tumours.

Vertical or horizontal orientation of foot radiographs does not affect image interpretation.

This study determined whether the orientation of dorsoplantar and oblique foot radiographs has an effect on radiograph interpretation. A test set of 50 consecutive foot radiographs were selected (25 with fractures, and 25 normal), and duplicated in the horizontal orientation. The images were randomly arranged, numbered 1 through 100, and analysed by six image interpreters.

Motion analysis of the glenohumeral joint during activities of daily living.

The shoulder complex has a larger range of motion (ROM) than any other joint complex in the human body, leaving it prone to numerous injuries. Objective kinematic analysis could yield useful functional insights that may assist clinical practice. Non-invasive optoelectronic motion analysis techniques have been used to assess the shoulders of five healthy subjects performing ROM tasks and 10 functional tasks of daily living.

Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial.

Background: Recent literature supports surgical intervention for shortened, displaced, mid-shaft clavicle fractures. We present the results of a randomized clinical trial comparing locked intramedullary fixation and plate fixation for short, displaced, mid-shaft clavicle fractures.

Materials And Methods: Local ethical approval was obtained and power analysis and sample size calculations were performed prior to commencement.

Pitfalls in the diagnosis of infection around the shoulder joint--report of three cases.

Infection around the shoulder joint is rare. Clinical suspicion and diagnostic imaging are required for accurate diagnosis. We present three cases that emphasise particular diagnostic challenges when dealing with infection around the shoulder joint.

A modified Weaver-Dunn procedure without need for internal fixation.

The shoulder as the most mobile joint in the body has a complex anatomy providing it with an increased range of motion, at the expense of its stability. The complex of ligaments and tendons around the acromioclavicular joint (ACJ) is prone to injury especially during sporting activity or following falls onto the apex of the shoulder. The original classification of ACJ dislocations having been modified by Rockwood suggests that types III to VI injuries may benefit from surgical intervention.

Bilateral glenohumeral septic arthritis secondary to retroperitoneal abscess.

Glenohumeral septic arthritis is rare and usually a result of Staphylococcus aureus infection. Gram-negative septic arthritis is on the increase and is usually associated with intraabdominal pathology. We present a case of bilateral E.

Long-stem revision prosthesis for salvage of failed fixation of extracapsular proximal femoral fractures.

A retrospective review was made of radiographs and case notes of patients with failed fixation of extracapsular proximal femoral fractures subsequently managed with long-stem revision arthroplasty. Follow-up radiographs, objective scoring, mobility, and complications were assessed. Twenty five hips were managed with long-stem hip arthroplasty in 24 patients with a mean age of 73 years.

Ankle instability.

Acute ankle sprains are common, and if inadequately treated may result in chronic instability. Lateral ankle injuries are most common, with deltoid injuries rare and associated with ankle fractures/dislocation. Medial ankle instability is rare.

Peroneal tendons subluxation.

Subluxation of the peroneal tendons is uncommon. It occurs especially in skiing, soccer, basketball, rugby, ice skating, judo, sprint, water-skiing, mountaineering, and gymnastics. We present an overview of the injury, with the classification commonly used.

Mastectomy scars following breast reconstruction: should routine histologic analysis be performed?

Background: There is some debate in the recent literature regarding the routine submission of mastectomy scars for histologic analysis when performing delayed breast reconstructions. The aim of this study was to review the relevant publications and evaluate the practice of routine histologic examination of mastectomy scars.

Methods: The authors conducted a retrospective review, across three regional plastic and reconstructive surgery units, of 433 patients who had 455 scars routinely sent for histologic examination following delayed breast reconstruction between January of 2000 and December of 2006.

Management of acute and chronic ankle instability.

Acute lateral ankle ligament injuries are common. If left untreated, they can result in chronic instability. Nonsurgical measures, including functional rehabilitation, are the management methods of choice for acute injuries, with surgical intervention reserved for high-demand athletes.

Standardised proformas improve patient handover: Audit of trauma handover practice.

Background: The implementation of the European Working Time Directive has meant the introduction of shift patterns of working for junior doctors. Patient handover between shifts has become a necessary part of practice in order to reduce the risk of medical errors. Data handed over between shifts are used to prioritise clinical jobs outstanding, and to create theatre lists.

Tibial tubercle osteotomy for access during revision knee arthroplasty: Ethibond suture repair technique.

Background: Tibial Tubercle Osteotomy has shown much promise in revision total knee replacement. Methods of repair previously described include screw and wire fixation. Both methods have significant complications.