Injury
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English Major Trauma Centres (MTCs) were established in April 2012. Increased case volume and complexity has influenced trauma and orthopaedic (T&O) core surgical training in these centres. ⋯ Introduction of a departmental core surgical trainee rota utilising a 'problem-based' model can significantly improve T&O core surgical training in MTCs.
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The surgical management of atypical femoral fractures (AFFs) is complex in cases with severe bowing of the femur, being associated with a high rate of failure. Our first aim was to use preoperative templating and 3D printed model characterise the technical difficulties associated with use of current commercially available intramedullary nail (IMN) systems for the management of AFFs with severe bowing. Our second aim was to use outcomes of our 3D printing analysis to define technical criteria to overcome these problems. ⋯ Commercially available IMN systems showed mismatch with severely bowed femurs. Our simulation supports that fit of these systems can be improved using an IMN system with a small radius of curvature and diameter, and by applying specific operative procedures.
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Supracondylar femoral fractures are considered uncommon in children; however, they are frequently associated with complications. To date, the optimal surgical approach for these fractures remains unclear. ⋯ Level III.
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Bruising is one of the most common types of injury clinicians observe among victims of violence and other trauma patients. However, research has shown commonly used qualitative description of cutaneous bruise colour via the naked eye is subjective and unreliable. No published work has formally evaluated the reliability of tristimulus colourimetry as an alternative for assessing bruise colour, despite its clinical and research applications in accurately assessing skin colour. The purpose of this study was to systematically evaluate the test-retest and inter-observer reliability of tristimulus colourimetry in the assessment of cutaneous bruise colour. ⋯ With consistent placement, the tristimulus colourimetry is reliable for the objective assessment and documentation of cutaneous bruise colour for purposes of clinical practice and research. Recommendations for use in practice/research are provided.