The FORCE study is in
@TheLancet
-
has awesome stuff to implement result - ED pathway, animations & patient info leaflets (multiple languages).
Thanks to
@PERUKItweep
and everyone who made it possible.
Excited to be awarded an “NIHR Research Professorship”.
Awesome stuff to come…
Thank you to all the Ortho & ED collaborators, trials teams, research nurses/ physios, ortho/ ED trainees and parents and young people who advise and participate.
It’s hugely appreciated 😀.
Eight outstanding researchers join an esteemed group of leading health and care researchers, as the latest cohort of NIHR Research Professors and NIHR Global Research Professors is announced.
Read more:
Breaking news from the
@BritOrthopaedic
conference about the .
We’ve done it 🤩🤩🤩🙏 - the impossible trial fully recruited 😃
Thank you teams throughout the UK, Australia & NZ.
Thanks also to
@bbcnickrobinson
😜
It’s started...
Is leaving these fractures to remodel (in those up to 10years old) as good as reducing +/- fixing them? An RCT....
First patient recruited by
@SOHNHS_Research
within a few hours of opening! 🥳
749 to go!
@BritOrthopaedic
@PERUKItweep
It was a huge honour yesterday to be awarded Fellowship ad hominem from
@RCSEd
and to give the graduation address.
A very special day.
Thank you to
@profp_edinsurg
, Prof Robin Paton and the whole
@RCSEd
team.
Congratulations to our special awardees Professor Mark Callery and Professor Daniel Perry who received Fellowship in Surgery ad hominem. Also, to Dr Ravikumar Gopalakrishnan and Mr Jose M Ramia-Angel who were awarded Fellowship in Surgery without Examination.
#RCSEdDiploma
BIG orthopaedic news from 2022 in the highest impact medical journals…
Starting with
@NEJM
…
1, Cement in Hip Fractures
2, Treating Achilles rupture
@TheLancet
coming next.
“Research in children’s orthopaedics is impossible” - Everyone said in 2015.
Then:
143 centres (300 surgeons) in Britain set about multi centre research…
Main aims: discover if multicentre research is possible & get feasibility data for RCTs.
Supported by
@NIHRcommunity
. 1/X
British Orthopaedic Surgery Surveillance Study -
A prospective nationwide cohort (143 hospitals!) of Perthes’ Disease & Slipped Epiphysis with 2-year follow-up.
Coming to the
@BoneJointJ
in April….be excited!
My family is now “fully branded” modelling
@AlderHey
pajamas!
I’m told dog ones are also available - though that’s a fight not worth having with a puppy!
Thanks
@AlderHeyCharity
and
@Matalan
“Patients won’t ever accept it”, was the response from many surgeons at the beginning of the CRAFFT study.
Here is a comment from one family of a completely off-ended distal radius after healing (with permission)
Amongst all the excitement of this massive poll of 1300 people - I forgot to tell you what was done….
(4) No reduction, nice cast alone.
See the power of remodelling!
7 year old boy….what you going to do?
(1) Reduce and cast
(2) Reduce and wire
(3) Reduce and plate
(4) No need to reduce (nice cast alone)
@BSCOS_UK
@POSNA_org
@OCTRUctu
BIG ORTHO PAPERS 2022 -
@TheLancet
was busy with orthopaedics in 2022.
Rotator Cuff
Torus Fractures in kids
ACLs
Open Fractures
Here is part 1…(both from
@NIHRresearch
)
Pleased to have been appointed Surgical Specialty Lead for Orthopaedic Clinical Trials
@RCSnews
. Hope to continue the growth in Orthopaedic trials across the U.K., in partnership with
@NIHRcommunity
,
@NIHRresearch
and other major funders
@VersusArthritis
.
“You can’t do randomised studies in children’s surgery”
Think again….
284 medial epicondyle fractures fairly split (randomised) between surgery and no surgery.
50 to go. 💥
Thanks to an awesome international team.
An honour to be invited to write about
#PerthesDisease
with one of the clinical giants - Dr Benjamin Joseph.
It’s freely available online…. summarising everything we know!
Great to get a copy of this book…
Shows how very cool remodelling is in kids.
Page 50 has a beautiful CRAFFT style XR! We’ve seen a lot of these in the study which is awesome!
Thank you
@Davembmd
.
Wow!
A whole massive session at
@BritOrthopaedic
congress hearing the results of multiple
@NIHRresearch
RCTs. How times change.
Evidence in orthopaedics - it’ll never catch on 😜!
You an Ortho or ED trainee looking for an amazing QI project….?
Implement pathway.
Bring Lancet evidence into your world -
(I’m keen to hear how it goes, or see the the results of subsequent audits).
@PERUKItweep
@BSCOS_UK
Not often recognised Orthopaedic surgery saves lives in elderly with hip fractures...
Our paper shows success of
@NHSEngland
policy to reward best-care (orthogeriatrics, timely op etc)
>1000 extra lives saved in England/ year.
@RCSnews
@BritOrthopaedic
@BoneJointJ
@RCP_FFFAP
Even a video for you to explain to families and for you to use in waiting rooms…!
Buckle (torus fractures) don’t need follow up.
Buckle (torus fractures) can be offered a bandage (that most kids/ families discard quickly).
How to manage forearm fractures in kids….(intended for core/ specialist trainees/ residents approaching exams).
A bit of level 1 evidence, the odd guideline and a healthy dose of orthopaedic anecdote 😜 (working on changing that!)
@bota_uk
Full text
7 year old boy….what you going to do?
(1) Reduce and cast
(2) Reduce and wire
(3) Reduce and plate
(4) No need to reduce (nice cast alone)
@BSCOS_UK
@POSNA_org
@OCTRUctu
Consensus from
@BSCOS_UK
on the management of DDH in babies.
However, “none of the areas of consensus are based on high-quality evidence”
Bring on RCTs
@NIHRresearch
It’s International Clinical Trials Day…and it’s ☀️!
Playgrounds will be full, trampolines washed off and water slides out….(and I’m oncall 😬).
Ortho bro’s, trainee ortho bro’s and paediatricians who like bones….
recruit to the kids trauma trials 😊
We’re improving screening for dislocated hips in babies in England -
To record better information as standard…
To answer lots of uncertainties using RCTs in usual care.
- How to screen?
- When to screen?
- How to treat?
- When to treat?
Watch how…
We are mindful that Thursday is “International Talk like a Pirate Day”.
We’ve put an emergency ethics amendment to adapt our kids trials accordingly...
Arrrrrgh.
@Oxford_Trauma
@PERUKItweep
@BSCOS_UK
Are we doing too much for distal radius fractures in children?
Here is everything I know from , along with what’s happening in
Evidence based fracture care - do it!
@PERUKItweep
@BritOrthopaedic
@bota_uk
822 different hip replacements used in the NHS...but the best results are from the unit who use one type for everyone (Royal Devon & Exeter).
A very thought provoking study
@NHSGIRFT
@BritOrthopaedic
@bota_uk
We should have a good reason to move way from established devices.
FORCE is getting really exciting...
The protocol and stats analysis plan now in
@BoneJointOpen
.
906 recruited.
21 kids 4-7 years old needed & 6 weeks f/u.
Then we’ll have an awesome result - the first acute study completely online - thanks
@PERUKItweep
@Oxford_Trauma
JUST PUBLISHED!: A multicentre prospective randomized equivalence trial of a soft bandage and immediate discharge versus current treatment with rigid immobilization for torus fractures of the distal radius in children
@MrDanPerry
#torusfracture
Reflecting how cool this was….
⭐️334 children with a relatively rare injury randomised
🌟between Surgery and No Surgery
⭐️ from 73 hospitals
🌟in 6 countries (England, Scotland, Wales, Northern Ireland, Australia and NZ).
⭐️by clinicians most of whom hadn’t done research.
NASA announce a Mars landing....
We can announce that we have landed support from
@captainstarship
to involve New Zealand in the
@NIHRresearch
’s exciting children’s .
Making our children’s research (practically) intergalactic.
It’s not often Kids Orthopaedics has a real life RCT!
DDH Hip Bracing....Do we splint Graf 2Bs?
2B or not 2B....have we got the answer.
(Spoiler Alert - splinting no apparent advantage in stable hips)
@BSCOS_UK
Was a huge privilege to be welcomed by faculty from
@Harvard
.
We learned huge amounts from clinicians and senior leaders that we’ll take back to our homes across the world. We also had lots of fun 😉
Thank you for the opportunity
@DrAntoniaChen
@roberthiggins32
@harvardortho
Over 5,000 patients with
#COVID19
are now taking part in the RECOVERY trial at over 160 NHS sites across the country. The NIHR-supported trial is leading the way in testing a range of potential treatments for COVID-19 disease
#PriorityCovidResearch
SCIENCE Trial - Surgery or Casts for Injuries of the (Medial) Epicondle in Children's Elbows. NIHR's 1st entirely Digital Trial. Ethics & HRA approval done - now we need you! It's a rare injury so we need every ortho & ED team onboard!
@BSCOS_UK
@PERUKItweep
@BritOrthopaedic
1of2
“More deaths from trauma than from all communicable diseases combined - though 1% research funding compared to 36% for communicable disease” - Jim Harrison, AO Alliance.
Developing world Trauma research now led by
@DrSiGraham
from
@LSTMnews
, funded by
@wellcometrust
Orthopaedic dogma prevails - 6 weeks in a cast makes everything better. Though, is it really the best for the child & family?
Best (albeit iffy!) evidence supports the approach of
@Peds_Ortho
(see pic).
Is an RCT needed (or too much!) to resolve this?
The UK General Medical Council have updated “Good Medical Practice” (the rules for doctors).
It includes (for the 1st time) research….
It formalises research as part of normal practice that all (good!) doctors should be part of 😃.
Children’s Emergency & Orthopaedic Trials.
Trainees...a video to show you how easy it is to recruit using our online platform.
With the NIHR Associate PI scheme, every hospital can be onboard!
Ortho trainees…
Dream about an awesome publication for ARCP?
Get involved in UK & Aus/NZ clinical trials.
Simple…
(1) contribute 2 medial epicondyle fractures.
(2) contribute 3 displaced wrist fractures.
Full rules below….
Lots of med students & trainees are currently missing clinical teaching.... here is a video summary of our JAMA paper for "an evidence based approach to the hip examination...."
@bota_uk
@ASiTofficial
@AMAmedstudents
@BMAstudents
The is now RECRUITING in the UK 😍🥳🤜🤛🏼
An RCT of SCFE (SUFE) with Severe Impingement - Open reduction vs. Pinning-In-Situ
The number 1 research priority from
@BSCOS_UK
Funded by the UK government through
@NIHRresearch
😊
Thanks
@Oxford_Trauma
The BASIS study has now randomised 119 adolescents (that’s more than the biggest prior scoliosis trial - BRAIST - which randomised 116). Scoliosis teams have become a force in research - 💥.
@NIHRresearch
@CTRU_Sheffield
@BritScoliosis
280 children randomised - 84% of total, with >90% primary outcome f/u.
>70 hospitals, 6 countries and loads of awesome surgeons, ED docs, nurses, physiotherapists & research teams.
Thank you 🙏
@NIHRresearch
@BritOrthopaedic
@BSCOS_UK
@OCTRUctu
Nashville
@POSNA_org
was great fun….though I never quite understand 6am start times!!
Very proud of
@GallowayAdam
for doing such a great job of presenting his
@NIHRcommunity
PhD progress about Perthes’ Disease.
(Great to catch up with friends - even line dancing and
@opry
!)
It’s started!!
@NIHRresearch
’s first completely online trial...text message follow-up etc etc.
Who‘ll recruit first? 25 hospitals visited, 10 open and 40+ more planned.
Who said Ortho Surgeons and ED docs can’t do research!
SCIENCE Trial - Surgery or Casts for Injuries of the (Medial) Epicondle in Children's Elbows. NIHR's 1st entirely Digital Trial. Ethics & HRA approval done - now we need you! It's a rare injury so we need every ortho & ED team onboard!
@BSCOS_UK
@PERUKItweep
@BritOrthopaedic
1of2
The
@NIHRresearch
SCIENCE study has started in New Zealand.
Welcome StarShip kids hospital (Auckland) & Invercargill 👏
94 recruits to go…getting closer 💥