Credits JTO Editorial Team l l l l
Bob Handley (Executive Editor) Rhidian Morgan-Jones (Editor) David Warwick (Medico-Legal Editor) Tricia Campbell (Trainee Section Editor)
BOA Executive l Don McBride (President) l Phil Turner (Immediate Past President) l Bob Handley (Vice President) l John Skinner (Vice President Elect) (Honorary Treasurer) l Simon Hodkinson (Honorary Secretary) l Deborah Eastwood
BOA Staff Executive Office Chief Operating Officer
- Justine Clarke
Personal Assistant to the Executive
- Celia Jones
Education Advisor
- Lisa Hadfield-Law
Policy and Programmes Director of Policy and Programmes
- Julia Trusler
Programmes and Committees Officer
- Harriet Wollaston
Educational Programmes Assistant
- Eliza Khalid
Communications and Operations Director of Communications and Operations
- Emma Storey
BOA Elected Trustees l Don McBride (President) l Phil Turner (Immediate Past President) l Bob Handley (Vice President) l John Skinner (Vice President Elect) (Honorary Treasurer) l Simon Hodkinson (Honorary Secretary) l Deborah Eastwood
Interim Director of Communications and Marketing
- Annette Heninger
Marketing and Communications Officer
- Sabrina Nicholson
Membership and Governance Officer
- Natasha Wainwright
Education and Online Exam Project Manager
- May Elphinstone
Publications and Web Officer
- Nick Dunwell
l Colin Esler
Finance
l Peter Giannoudis
Director of Finance - Liz Fry
l Grey Giddins l Robert Gregory l Anthony Hui l Andrew Manktelow
Deputy Finance Manager - Megan Gray Finance Assistant - Hayley Oliver
l Ian McNab
Events and Specialist Societies
l Fergal Monsell
Head of Events - Charlie Silva
l Rhidian Morgan-Jones
Events Administrator - Venease Morgan
l Hamish Simpson l Arthur Stephen l Duncan Tennent
Exhibitions and Sponsorship Coordinator
- Emily Farman
UKSSB Executive Assistant - Henry Dodds
Copyright
Copyright© 2020 by the BOA. Unless stated otherwise, copyright rests with the BOA. Published on behalf of the British Orthopaedic Association by: Open Box M&C
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From the Executive Editor Bob Handley
S
trange and strained times. Writing an editorial that will be read a few weeks later is always risky business but even more so when surrounded by such volatility. It is, however, the essence of so much of what we do; we make the best judgement we can in the circumstances that prevail and proceed. Whether those circumstances be a tricky problem in theatre or the fallout from a pandemic we carry on. This special edition of the JTO charts some of our efforts. The normal printed JTO had been cancelled but then an opportunity arose to partially resurrect it as special on-line PDF version. To keep up with the ever changing world of COVID-19 we had already started publishing articles in a rapid turn-around Journal called the TJTO&C or the Transient Journal of Trauma Orthopaedics and the Coronavirus. This PDF version of JTO is in the main a compilation of those articles, with some updates and commentaries. The swing in the pervading mood over the last eight weeks has been extraordinary; an acute fear of being overwhelmed by pandemic respiratory failure morphing into a pervasive threat of endemic Coronavirus. The articles we have chosen reflect this mood swing. Some document the redeployment and experiences of individuals in the acute phase. ‘An orthopaedic surgeon’s diary at the Nightingale Critical Care Unit’ page 18 will be read in the future in a way similar to how I heard my parents describe the Blitz. A personal story of ‘Coronavirus (COVID-19): My experience of testing positive’ page 16 will hopefully soon seem like a relic of a bygone age. They are a record of what happened, a Pepys diary of 2020. There are more philosophical issues that arose. The article that promoted the most debate was that detailing SHiFT, a potential response to the anticipated collapse in resources which threatened. What would be the consequences of this on managing our normal urgencies, the exemplar for T&O being the hip fracture. It confronts triage of a condition with a risk of mortality, which for most of us has only ever been role play. We did it on our ATLS course but there was now the prospect of it happening for real. The Armageddon that was feared did not materialise but chronicling the planning exercise is of value. The acute loss of resource may now be replaced by a chronic one. With a morass of unpredictability awaiting; slower operating, fewer beds, PPE, staff testing, patient testing, consent, residual fear, the list could go on. This continues to generate noise in the unending health dilemma of whether we need central diktat or local solutions; one with its inflexibility the other risking a postcode lottery. A full retrospective can be had in a future bumper edition of JTO or a component of a Congress, but we have no idea when. Until then the TJTO&C will provide a forum. It is now customary to sign off with the invitation or encouragement to keep safe, the inference often being to hunker down to stay alive. I like the adage that “Life is movement and movement is life.” I don’t think that this was intended to apply only to the muscles used in breathing. In T&O our most common objective is restoration of function, this should now be the objective for both society and the individual. Phase one of COVID-19 could be summed up as “Be safe, don’t do anything” now we need “Do something but safely!” Those could just be hollow words but what better example could we have of the benefits of restoring function than Sir Tom. The raw statistics don’t look that good for a man in his late 90s with a hip fracture, but a broad smile and £33 million for the NHS is quite a result. We salute you Sir! n Cover image courtesy of Mike Dawson: Painting of Captain Sir Tom Moore.
JTO | Volume 08 | Issue 02 | June 2020 | boa.ac.uk | 03
