Management of Scapula Fractures at a Level 1 Trauma Centre in the United Kingdom.

Background Scapular fractures, an uncommon injury that can be brought on by a high-energy mechanism because of its proximity to the pectoral and shoulder muscles, are frequently linked to fatal injuries. This study aimed to compare surgical versus conservative treatment of scapular fractures and the results of treated patients. Methods The traumatic scapular fracture patients in this cross-sectional study (n = 391) were treated at a major trauma centre (level 1) in the United Kingdom between 2012 and 2018.

Salvage Total Hip Replacement for Failed Proximal Femoral Fracture Fixation.

Introduction: Salvage arthroplasty for failed proximal femoral fracture fixation is a complex procedure. This involves the removal of the primary failed or broken implant followed by a hip joint replacement procedure. The complications and technical difficulties associated with these surgeries are often difficult to anticipate.

Parastomal Varices as an Atypical Source of Bleeding From a Urostomy in a Patient With Alcoholic Liver Disease.

Parastomal varices are an uncommon but significant source of hemorrhage in patients with portal hypertension, often posing diagnostic and therapeutic challenges. We report the case of a 73-year-old male with a history of alcoholic liver disease and a urostomy following cystoprostatectomy for bladder cancer. The patient presented with profuse bleeding from his urostomy site.

An Unusual Presentation of Urinary Retention in a Young Male Patient With Neurofibromatosis Type 1.

Acute urinary retention (AUR) in young adults is an uncommon presentation often signalling an underlying pathology, particularly when associated with genetic conditions like neurofibromatosis type 1 (NF1). We report the case of a 25-year-old male with a known family history of NF1, who presented with acute urinary retention and progressive pelvic pain. Physical examination was notable for axillary freckling and café-au-lait spots, consistent with NF1.

Accuracy of Outsourced Radiology Reports in Emergency Surgical Care: Do They Provide a High-Quality, Cost-Effective Service?

Background Computed tomography (CT) scans play a crucial role in emergency surgical care, serving both diagnostic and prognostic functions. They significantly contribute to timely and effective patient care. This study aims to compare abdominal CT scan reports prepared by locally employed radiologists with those from outsourced radiology reporting services for patients presenting with acute surgical conditions.

Peri-Operative Hypothermia in Trauma Patients: A Retrospective Cohort Analysis at a Busy District General Hospital Within the National Health Service (NHS).

Introduction:  Perioperative hypothermia is defined as a patient's core body temperature of less than 36°C, which can lead to several complications. Even mild hypothermia increases the incidence of post-operative wound infection, post-operative ischaemic cardiac events and intra-operative blood loss and prolongs post-operative recovery. It is, hence, essential to maintain and provide normothermia during the perioperative phases for optimal surgical results and patient satisfaction.

The Use of Floseal Hemostatic Agent for Local Bleeding Control in Fungating Breast Cancer: A Case Report and Review of Literature.

Advanced breast cancer can present with bleeding tumors that are difficult to control using traditional techniques. The use of topical agents has been reported in the local management of bleeding malignant tumors. We report a challenging case of persistent bleeding in a 40-year-old female patient with metastatic breast cancer, presenting with significant uncontrollable bleeding from the fungating breast tumor where conventional measures failed to halt blood loss.

Leptomeningeal Disease Secondary to Invasive Ductal Carcinoma of the Breast: A Rapidly Progressive and Fatal Complication.

Leptomeningeal disease (LMD) is a rare yet serious complication of advanced malignancy, often seen in breast cancer and associated with a poor prognosis.  This case report highlights the rapid progression and diagnostic challenges encountered in a woman in her 40s with advanced breast cancer who presented with severe headaches, absence seizures, and diplopia. The patient's complex past history included invasive ductal carcinoma, prior brain metastasis, and recent craniotomy, which added significant challenges to diagnosis and management.

Displaced Pediatric Supracondylar Fracture (Gartland Type II and III): The Impact of Wire Fixation Type.

Introduction Supracondylar fractures are common in children. Percutaneous K-wire fixation is an accepted standard treatment for displaced supracondylar fractures in children, but the ideal wire configuration remains controversial. This study aimed to review the radiographic outcome and complications of Gartland type II and type III supracondylar fractures treated by the crossed and lateral K-wire fixation.

UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants.

Eosinophilia is a common finding in returning travellers, migrants and other travelling groups. In this setting it often indicates an underlying helminth infection. Infections associated with eosinophilia are frequently either asymptomatic or associated with non-specific symptoms but some can cause severe disease.

What Is the Accuracy of Clinical Staging for Stage III-Single-station N2 NSCLC? A Multi-Centre UK Study.

Introduction: Single-station N2 (ssN2) versus multi-station N2 has been used as a selection criterion for treatment recommendations between surgical versus non-surgical multimodality treatment in stage III-N2 NSCLC. We hypothesized that clinical staging would be susceptible to upstaging on pathologic staging and, therefore, challenge this practice.

Methods: A retrospective study of prospectively collected routine clinical data for patients with stage III-N2 NSCLC that had completed computed tomography (CT), positron emission tomography (PET), and staging endobronchial ultrasound (EBUS) and had been confirmed clinical stage III-ssN2 at multidisciplinary team discussion and went on to complete surgical resection as the first treatment to provide pathologic staging.

The use of predictive modelling to determine the likelihood of donor return during the COVID-19 pandemic.

Artificial intelligence (AI) uses sophisticated algorithms to "learn" from large volumes of data. This could be used to optimise recruitment of blood donors through predictive modelling of future blood supply, based on previous donation and transfusion demand. We sought to assess utilisation of predictive modelling and AI blood establishments (BE) and conducted predictive modelling to illustrate its use.

Preventing Pilonidal Sinus Recurrence With Laser Hair Epilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Pilonidal sinus disease (PSD) is a common condition associated with significant morbidity and healthcare costs. High recurrence rates still pose a considerable challenge in managing PSD, with no universally accepted guideline in place to guide management. Laser hair epilation offers a way to reduce recurrence rates with reports within the current literature demonstrating positive outcomes compared to alternative approaches.

Improving lung point-of-care ultrasound (POCUS) training and accreditation - a multidisciplinary, multi-centre and multi-pronged approach to development and delivery using the action learning process.

Background: Point-of-Care Ultrasound (POCUS) consists of a range of increasingly important imaging modalities across a variety of specialties. Despite a variety of accreditation pathways available in the UK, lung POCUS training remains difficult to deliver and accreditation rates remain suboptimal. We describe a multidisciplinary, multi-centre, and multi-pronged approach to lung POCUS education within a region.