Frontal fibrosing alopecia: survey of severity assessment methods in routine clinical practice and validation of the International Frontal Fibrosing Alopecia Cooperative Group measurement guidance.

Background: The lack of validated and responsive outcome measures in the management of frontal fibrosing alopecia (FFA) significantly limits assessment of disease progression and treatment response over time.

Aim: To understand how FFA extent and progression is currently assessed in UK specialist centres, to validate components of the International FFA Cooperative Group (IFFACG) statement on FFA assessment, and to identify pragmatic advice to improve FFA management in clinic.

Methods: Consultant dermatologists with a specialist interest in hair loss (n = 17) were invited to take part.

Multimodal Biomarkers Quantify Recovery in Autoimmune Autonomic Ganglionopathy.

Objective: The objective of this study was to evaluate patients with ganglionic acetylcholine receptor antibody (gAChR-Ab) positive autoimmune autonomic ganglionopathy using a multimodal testing protocol to characterize their full clinical phenotype and explore biomarkers to quantify immunotherapy response.

Methods: We conducted a cohort study of 13 individuals (7 women, 21-69 years of age) with autonomic failure and gAChR-Ab >100 pM identified between 2005 and 2019. From 2018, all patients were longitudinally assessed with cardiovascular, pupillary, urinary, sudomotor, lacrimal and salivary testing, and Composite Autonomic Symptom Score (COMPASS-31) autonomic symptom questionnaires.

Lapidus, a Percutaneous Approach.

Described in the early 1900s by Albrecht and Lapidus, the Lapidus procedure became an important tool in the armamentarium. With the increase of percutaneous techniques, the development of a percutaneous Lapidus seemed obvious.

External Quilting: New Technique to Avoid Haematoma in Gynaecomastia Surgery.

Background: Haematoma after gynaecomastia surgery is the most common early complication. It may necessitate a return to the theatre and cause increased infection risk, poor wound or delayed healing, and abnormal scar. Strategies to avoid haematoma range from perioperative blood pressure control to the use of tranexamic acid and compressive dressings.

Arthroscopic Bankart repair with remplissage for non-engaging Hill-Sachs lesion in professional collision athletes.

Background: The present study aimed to determine whether arthroscopic remplissage with Bankart repair is an effective treatment for improving outcomes for collision athletes with Bankart and non-engaging Hill-Sachs lesions.

Methods: Twenty collision athletes underwent arthroscopic Bankart repair with posterior capsulotenodesis (B&R group) and were evaluated retrospectively, using pre- and postoperative WOSI (Western Ontario Shoulder Instability), EQ-5D (EuroQOL five dimensions), EQ-VAS (EuroQol-visual analogue scale) scores and Subjective Shoulder Value (SSV). The recurrence and re-operation rates were compared to a matched group with isolated arthroscopic Bankart repair (B group).

Missed fractures of the greater tuberosity.

Background: Fractures of the greater tuberosity may result from a variety of mechanisms. Missed injury remains a persistent problem, both from a clinical and medico-legal point-of-view. Few studies on this topic are available in the literature.

Exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type.

Purpose: To explore exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type and to explore patient experiences of physiotherapy.

Methods: A cross sectional questionnaire survey design was used to collect quantitative and qualitative data from adult members of the Hypermobility Syndromes Association and Ehlers-Danlos Syndrome Support UK. Descriptive and inferential statistics were used to analyse the data.

Contemporary approach to joint hypermobility and related disorders.

Purpose Of Review: Joint hypermobility is a common, although largely ignored physical sign. Joint hypermobility is often asymptomatic but may be a feature of an underlying genetic disorder with systemic manifestations. The present article presents a comprehensive approach to considering joint hypermobility and clinically related issues in children and adults.

Syndesmosis Stabilisation: Screws Versus Flexible Fixation.

Orthopedic surgery is not short of situations where there is controversy regarding optimum management. Treating ankle syndesmosis injuries is an example where practice varies widely and there are many questions that remain unsatisfactorily answered. When addressing the type of syndesmosis stabilization that is required it is essential to ascertain the extent of instability.

Facilitating shared decision-making with breast augmentation patients: Acceptability of the PEGASUS intervention.

Background: PEGASUS is an intervention to facilitate shared decision-making by helping prospective patients consider their expectations of surgery, so that surgeons have a clear understanding of their individual goals. To date, shared decision-making interventions within aesthetic surgery are lacking. The present mixed methods study therefore explored the acceptability of implementing PEGASUS into routine private practice with breast augmentation patients and aesthetic providers.

National survey to evaluate musuloskeletal health in retired professional ballet dancers in the United Kingdom.

Objectives: To explore the musculoskeletal health of retired professional ballet dancers in the United Kingdom (UK).

Design: Online national survey.

Participants: Retired professional ballet dancers living in the UK.

Percutaneous Surgery for Severe Hallux Valgus.

Severe hallux valgus is a challenge to treat. If the basal osteotomy is a well known surgery for severe deformity, the chevron osteotomy is usually used in mild to moderate deformity. With a accurent fixation the chevron can also be used in severe deformity.

Hyperbaric oxygen for patients with chronic bowel dysfunction after pelvic radiotherapy (HOT2): a randomised, double-blind, sham-controlled phase 3 trial.

Background: Hyperbaric oxygen has been used as a therapy for patients experiencing chronic intestinal syndromes after pelvic radiotherapy for decades, yet the evidence to support the use of this therapy is based almost exclusively on non-randomised studies. We aimed to provide conclusive results for the clinical benefits of hyperbaric oxygen in patients with chronic bowel dysfunction after radiotherapy for pelvic malignancies.

Methods: HOT2 was a double-blind, sham-controlled, phase 3 randomised study of patients (≥18 years) with chronic gastrointestinal symptoms for 12 months or more after radiotherapy and which persisted despite at least 3 months of optimal medical therapy and no evidence of cancer recurrence.

Minimally Invasive Surgery Osteotomy of the Hindfoot.

A minimally invasive surgical approach has been developed for hindfoot as well as forefoot procedures. Percutaneous techniques have been evolving for more than 20 years. Many conventional surgical techniques can be performed percutaneously after training.

Percutaneous Surgery of the Forefoot.

This article describes some of the common techniques used in percutaneous surgery of the forefoot. Techniques such as minimally invasive chevron Akin osteotomy for correction of hallux valgus, first metatarsophalangeal joint cheilectomy, distal minimally invasive metatarsal osteotomies, bunionette correction, and hammertoe correction are described. This article is an introduction to this rapidly developing area of foot and ankle surgery.

The influence of joint hypermobility on functional movement control in an elite netball population: A preliminary cohort study.

Objectives: To ascertain the prevalence of General Joint Hypermobility (GJH) and Joint Hypermobility Syndrome (JHS) in elite level netballers. To investigate whether GJH influences functional movement control and explore whether symptoms of dysautonomia are reported in this population.

Design: Observational within-subject cross-sectional design.

Effect of Intravenous Iron on Aerobic Capacity and Iron Metabolism in Elite Athletes.

Purpose: Iron-deficient athletes are often treated with long-term, low-dose iron therapy. Such treatments may be efficacious in correcting iron deficiency; however, the effect on acute and chronic iron metabolism and subsequent endurance capacity is less clear.

Methods: Fifteen national and international standard runners were identified as iron deficient nonanemic (IDNA) and assigned to either an intravenous iron treatment group or placebo group.

Plantaris injuries in elite UK track and field athletes over a 4-year period: a retrospective cohort study.

Purpose: The plantaris tendon is present in 98-100 % of people, and a potential relationship between the plantaris tendon and the development of Achilles tendinopathy has been postulated. There are no studies on the epidemiology of plantaris injuries in a sporting population. This retrospective cohort study presents the incidence, nature and outcome of plantaris injuries in elite British track and field athletes.

Nonunion of fifth metatarsal fractures.

Metatarsal fractures are those most frequently encountered in the foot. More than half of these are of the 5th metatarsal. The incidence is increasing, along with the activity levels of the general population.