01 Jun 2015

Volume 3 Issue 2


From the Editor

A lot has happened since the last issue of JTO was published, most importantly the official publication of the Getting it Right First Time report. There has also been something in the news about a general election but Colin Howie will touch on this in his Presidential article over the page. This issue touches on many interesting subjects. Our Vice President, Tim Wilton’s commissioning article and observations on the importance of viewing your own data gives focus to an important part of practice
(page 26).

There is a three-pronged focus on research with research priority setting and the James Lind Alliance (page 22), Major Trauma trials and their evolution (page 32) and finally how the NJR supports research (page 24).

The BOTA President’s, co-authored article on training in Europe gives food for thought. Medico-Legal issues include the second part of the Code of Practice (page 38) and the odd problem of whiplash in children (page 36).

What do you see on the front cover? It’s subject to your interpretation. The focus on the Peer-Reviewed Section is Hips. Our Guest Editor for this section was Andrew Hamer. You will find a general interest piece on the rise of big data; a scientific piece on VTE and a controversial piece about metal on metal from page 42. Our regular “How I Do…” piece submitted by a member of the Orthopaedic Trauma Society (OTS) follows these and focuses on the use of blocking wires to nail proximal tibial fractures (page 52).

We also pay tribute to colleagues, including two taken from us at an untimely age – J Tulloch Brown, John Goodall, Gamada Ayana and Andrew Sprowson (pages 54-55). Sadly the “In Memoriam” section for the September issue is already full with the loss of Tony Fogg, Steve Copeland, Frank Beddow and Robert Robins. Our thoughts are with their family and friends at this sad time.

We are receiving increasing numbers of letters and responses to the controversies and issues raised. Keep them coming!


Ian Winson – BOA Vice President Elect

Reference Lists


How Does the National Joint Registry Support Research?

1. www.gov.uk/government/uploads/system/uploads/attachment_data/ file/367788/Sir_Nick_Partridge_s_summa ry_of_the_review.pdf

2. www.hscic.gov.uk/dars  

3. www.njrcentre.org.uk/njrcentre/Research/Researchlibrary/tabid/313/Default.aspx

4. www.njrcentre.org.uk/njrcentre/Research/Researchrequests/tabid/305/Default.aspx

5. www.njrcentre.org.uk/njrcentre/default.aspx

6. www.njrcentre.org.uk/njrcentre/Research/NJRResearchFellows/tabid/314/Default.aspx 

Orthopaedic Trauma Surgeons in the UK Delivering World-Leading Clinical Research - That's a Joke!

1. Costa ML, Achten J, Parsons NR, Rangan A, Griffin D, Tubeuf S, Lamb SE on behalf of DRAFFT Study Group.  Percutaneous fixation with Kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial BMJ 2014;349:g4807 
2. Griffin D, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, Lamb SE; UK Heel Fracture Trial Investigators. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial. BMJ. 2014 Jul 24;349:g4483 
3. Rangan A, Handoll H, Brealey S, Jefferson L, Keding A, Martin BC, Goodchild L, Chuang LH, Hewitt C, Torgerson D; PROFHER Trial Collaborators.  Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial.  JAMA. 2015 Mar 10; 313(10):1037-47 
4. Willett K, Keene DJ, Morgan L, Gray B, Handley R, Chesser T, Pallister I, Tutton E, Knox C, Lall R, Briggs A, Lamb SE. Ankle Injury Management (AIM): design of a pragmatic multi-centre equivalence randomised controlled trial comparing Close Contact Casting (CCC) to Open surgical Reduction and Internal Fixation (ORIF) in the treatment of unstable ankle fractures in patients over 60 years. BMC Musculoskelet Disord. 2014 Mar 12;15:79.