Early provision of clinical information with an 'opt in' approach improves patient experience in tonsillectomy referrals.

Patients referred by their general practitioner (GP) with a definite diagnosis, for example, recurrent sore throat for consideration of tonsillectomy in adults, may wait for months without receiving any further clinical information from the hospital until their outpatient consultation. Prompt provision of condition-specific information after referral has received little attention despite considerable potential to enhance patients' understanding, thereby relieving uncertainty and anxiety, and facilitating shared decision-making.This study aimed to report the experience of patients with recurrent tonsillitis who had been sent a booklet outlining the benefits and risks of tonsillectomy immediately after GP referral.

Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital.

Objective: Healthcare faces the continual challenge of improving outcome while aiming to reduce cost. The aim of this study was to determine the micro cost differences of the Glasgow non-operative trauma virtual pathway in comparison to a traditional pathway.

Design: Discrete event simulation was used to model and analyse cost and resource utilisation with an activity-based costing approach.

The virtual fracture clinic: Reducing unnecessary review of clavicle fractures.

Introduction: We re-designed the outpatient management of trauma at our institution to eliminate appointments if there would be no change in management or information provision. All cases referred by the Emergency Department (ED) were reviewed at a Virtual Fracture Clinic (VFC) by an orthopaedic consultant and telephoned afterwards by a senior nurse. If face-to-face review was required, it was arranged at a specialist shoulder clinic.

Primary osseous tumours of the elbow: 60 years of registry experience.

Background: We present the largest series of surgically treated primary bone tumours of the elbow in the English literature (75 cases). We sought to identify characteristics specific to these lesions and recommend an investigatory protocol.

Methods: The national registry and case notes were reviewed between 1954-2014.

Satisfaction and functional outcome with "self-care" for the management of fifth metacarpal fractures.

Background: Fifth metacarpal fractures are common and comprise a significant proportion of traditional orthopaedic fracture clinic workload. We reviewed the functional outcome and the satisfaction of patients managed with a new protocol that promoted "self-care" and resulted in the discharge of most of these patients from the emergency department with no further follow-up.

Methods: A retrospective study was performed of patients discharged with a fifth metacarpal fracture between April 2012 to October 2012.

Functional outcome and satisfaction with a "self-care" protocol for the management of mallet finger injuries: a case-series.

Background: Mallet finger injuries are usually successfully treated non-operatively with a splint. Most patients are reviewed at least twice in a clinic after the initial presentation in A&E. A new protocol promoting "self-care" was introduced at our institution.

A new "virtual" patient pathway for the management of radial head and neck fractures.

Background: Minimally displaced radial head and neck fractures are common and the outcome with conservative treatment is generally excellent. A new protocol was introduced to manage patients with these suspected fractures at a major urban hospital. Simple, undisplaced fractures without other associated injuries or instability were discharged with structured advice but no further face-to-face review.

Total elbow replacement: outcome of 1,146 arthroplasties from the Scottish Arthroplasty Project.

Background And Purpose: Total elbow replacement (TER) is used in the treatment of inflammatory arthropathy, osteoarthritis, and posttraumatic arthrosis, or as the primary management for distal humeral fractures. We determined the annual incidence of TER over an 18-year period. We also examined the effect of surgeon volume on implant survivorship and the rate of systemic and joint-specific complications.