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Zimmer Biomet Trauma Travelling Fellowship to Ludwigshafen Daniel Burchette
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he Berufsgenossenschaftliche Unfallklinik (BG Klinik) Ludwigshafen is a dedicated trauma, orthopaedic and plastic surgery hospital and Level 1 trauma centre in the Rhineland-Palatine region of Germany. It forms part of the BGU group of trauma hospitals that are nationally renowned for their musculoskeletal trauma care. I was fortunate to spend a six-week BOA / Zimmer Biomet Travelling Trauma Fellowship with their acute traumatology team focussing on their extensive experience of intraoperative crosssectional imaging, which is a topic I have long been interested in, but not exposed to in my UK training. The majority of the six-week attachment was spent in the operating theatre suite with the acute traumatology team, observing and assisting in a wide range of acute trauma cases. During this time I observed and assisted in a broad range of extremity trauma operating, picking up ‘tips and tricks’ from their expert traumatology team and learning how they integrate 3D imaging into their routine theatre practice. Applied
to all periarticular fractures in this institution, the concept is simple: fix the fracture as per usual using fluoroscopy, before performing a scan to critically analyse the reduction, with a readiness and appetite to start again if required. Over the course of the fellowship the arguments were convincing; on a few occasions a seemingly good reduction on fluoroscopy was betrayed on scan, leading to intraoperative revisions of the fixation. I wish to thank the Head of the Acute Traumatology team, Dr Jochen Franke and his Oberarzt colleagues, Dr Benedict Swartman and Ann-Kathrin Blessing for their kind hospitality throughout my stay and taking the time to demonstrate and involve me in their work. Finally, I am supremely grateful to the British Orthopaedic Association and Zimmer Biomet for funding this opportunity. n
British Society for Children’s Orthopaedic Surgery (BSCOS) update Simon Barker and Dan Perry
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onsensus is booming in children’s orthopaedic surgery! Consensus guidelines are now available on the BSCOS website for DDH, Clubfoot and MSK Infection. The success of the infection guideline has now resulted in the publication of a new BOAST. An adolescent ACL injury BOAST has also resulted from joint working with BASK. There is lots of consensus – and lots of ongoing friendly debate! As a group we now know where we agree (and where we don’t!) and have committed to try to overcome variation through consensus until high-quality evidence is available.
08 | JTO | Volume 10 | Issue 02 | June 2022 | boa.ac.uk
The generation of evidence continues to be a growing (and is now a massive) part of BSCOS. The BOSS study was published in the BJJ in April and involved almost every centre in Britain treating SCFE and Perthes’ disease children. BOSS formally demonstrated the variation that occurs and the potential for RCTs. This has now resulted in an NIHR RCT being funded for children with severe SCFE (called BigBOSS) and another (hopefully to be) funded amongst children with Perthes’ disease. Our ongoing portfolio of NIHR RCTs continues to grow with the first big NIHR trial (FORCE – torus
fractures) soon to publish. Others are recruiting well with the sunny playground weather! The others going - Medial Epicondyles (SCIENCE – 60% recruited), Distal Radius Fractures (CRAFFT – 52% recruited). The new studies to look out for include ODDsocks (SH2 fracture RCT) and PICBone (decision making in infection cohort). There are even more to come (though they remain top secret… be excited!). The consensus is that children’s orthopaedics will soon be an awesome evidence rich zone – and we all agree that recruitment to studies is our team game!
