Effect of COVID-19 on a rural orthopaedic hip fracture service.

Aims: Our rural orthopaedic service has undergone service restructure during the COVID-19 pandemic in order to sustain hip fracture care. All adult trauma care has been centralised to the Royal Shrewsbury Hospital for assessment and medical input, before transferring those requiring operative intervention to the Robert Jones and Agnes Hunt Orthopaedic Hospital. We aim to review the impact of COVID-19 on hip fracture workload and service changes upon management of hip fractures.

Sternoclavicular joint.

The sternoclavicular joint is a saddle shaped, synovial joint and is the only skeletal articulation between the axial skeleton and the upper limb. Here, a reviewis provided of the anatomy, biomechanics, traumatic and atraumatic conditions, and management options for the various conditions described.

Early versus late surgery for closed ankle fractures.

Purpose: To compare the outcome after early versus late surgery for closed ankle fractures in terms of the length of hospital stay and infection rate.

Methods: Records of 95 men and 119 women aged 14 to 92 (mean, 46) years who underwent open reduction and internal fixation for ankle fractures during three 6-month periods in 2004, 2007, and 2010 were reviewed. 82 and 132 patients underwent surgery <24 hours and >24 hours after presentation, respectively.

Delayed presentation of an aspirated capsule endoscope.

Capsule endoscopy has revolutionized the investigation of small intestinal pathology with an increasing repertoire of indications. We present the first reported case of an aspirated capsule presenting after a long asymptomatic period that was removed with no permanent pulmonary sequelae. This report highlights a cohort of patients who could be susceptible to this rare complication.