Learning from minor injury care restructure during the COVID-19 pandemic: a phenomenological study of orthopaedic clinical leaders.

Background: During peaks of the COVID-19 pandemic, trauma and orthopaedic departments in England have been asked to support emergency departments by providing first contact care for minor injuries. The subsequent requirement for departmental restructure has resulted in a variety of service pathways across the country. This study aimed to explore the experiences of different clinical teams and identify any consistent themes or reflections, which could be applied to continuous improvement of minor injury care.

A Debilitating Orthopaedic Complication following Corticosteroid Therapy for Polymyalgia Rheumatica.

Avascular necrosis (AVN) of the scaphoid secondary to corticosteroid use is a rare entity. Previous reports in the literature refer to chronic steroid intake. We report a case secondary to low dose, short term use.

Tenodesis of the extensor carpi ulnaris for chronic, post-traumatic lunotriquetral instability.

We describe a technique of soft-tissue reconstruction which is effective for the treatment of chronic lunotriquetral instability. Part of extensor carpi ulnaris is harvested with its distal attachment preserved. It is passed through two drill holes in the triquetrum and sutured to itself.

Post-traumatic instability of the trapeziometacarpal joint of the thumb. Diagnosis and the results of reconstruction of the beak ligament.

In 28 patients with a solitary diagnosis of instability of the trapeziometacarpal joint because of a rupture of the anterior oblique ligament, reconstruction was carried out using a slip of the tendon of flexor carpi radialis. We were able to review 26 patients. The results after a follow-up of four years seven months showed that most (87%) had significant relief from pain and symptoms.

Biaxial total wrist replacement in patients with rheumatoid arthritis. Clinical review, survivorship and radiological analysis.

We have implanted 76 biaxial total wrist prostheses as a primary procedure in patients with rheumatoid arthritis of the wrist. A total of 66 was reviewed at a mean follow-up time of 52 months. Pain was relieved in 67% of the surviving wrist replacements.

Involuntary positional instability of the shoulder in adolescents and young adults. Is there any benefit from treatment?

We diagnosed 50 patients (58 shoulders) with a mean age at presentation of 17.3 years, as having involuntary positional instability of the shoulder. They were managed by a programme consisting of a careful explanation, analysis of abnormal muscle couples and then muscle retraining carried out by a specialist physiotherapist.

Pasteurella multocida infection of a total hip arthroplasty following cat scratch.

Pasteurella multocida is a well recognized cause of sepsis following animal contact particularly bites and scratches. Spread to prosthetic joints may occur particularly in immunocompromised patients. Immunocompromised patients with prosthetic joints should be warned that animals are potential sources of serious infection and urgent medical advice should be sought if bitten or scratched.