JTO
03 Jun 2024

JTO - June 2024

Volume 12 Issue 2

From the Executive Editor

The hard work continues as spring turns into summer and whilst often the thrust of the work is in dealing with numbers: numbers on the waiting list, the percentage theatre utilisation, numbers of overbookings, underutilisation etc., our energy should perhaps be directed to the field of human factors. The complex field of human factors as introduced by James Tomlinson can take up much ‘head space’ as depicted in the cover picture by Chryssa Neo, a ST3 in Edinburgh, but it is a recognition of these factors and their importance that does indeed make us human. An understanding of their relevance makes life safer for our patients (page 46) and for ourselves. An appreciation of diversity in design and the ergonomics of our workplace is also important (page 50) whilst Steven Yule introduces us to a whole new ball game (for me anyway) called surgical sabermetrics (page 53).

If human factors are important at home, they certainly must be so in the different and often challenging environments encountered during global surgery initiatives supported by our impressive trainees (page 38) and whilst running the Mercy Ships orthopaedic missions as described by Rachel Buckingham (page 34).

The kids I treat often ask for their pins and plates to take home with them for ‘show and tell’ at school, and I was interested to read about the current guidance on ownership and/or disposal of removed implants (page 42).

This edition of JTO also includes an introduction to the ‘new’ specialty of kids knee surgery (page 18) and reminds us that obesity must not be an exclusion to care that can transform lives (page 22). Perhaps for both paediatric knee conditions and obesity related problems, prevention is better than cure and certainly the remit of the fracture liaison services is to do just that – reduce the risk of secondary fractures. Andrew Gray comments how he himself is at risk of falls and what the services can do to help him and many of our patients! (page 16).

Teaching and training are always important aspects of our profession but we need to take care that we do not simply jump on each new bandwagon that passes by without evaluating whether or not it is going to be useful. The article by Kapil Sugand and Hiro Tanaka offers us some guidance on the role of simulation in formal orthopaedic training (page 26). Andrew Coppola and Vipin Asopa provide a similarly reasoned approach to the use of AI in Trauma and Orthopaedics and how it is affecting us now.

Remembering where we have come from should always be part of working out where we are headed. So it is fitting what whilst we embrace the excitement of the brave new world of technology that we are participating in, we remember the role of John Kirkup as the BOA archivist for many years as well as an orthopaedic colleague of note (page 56).

Whilst the world does remain in some turmoil, I hope that the summer brings the opportunity for a holiday with friends and family. 

 Deborah Eastwood, Immediate Past President 

 

Subspecialty Section

References

Guidance on the role of simulation in formal training by the British Orthopaedic Association

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A practical approach to artificial intelligence in trauma and orthopaedics

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Global surgery ‘the trainees’ perspective’: Ten things we have learnt so far...

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2.     Meara, J. G., Leather, A. J. M., Hagander, L., Alkire, B. C., Alonso, N., Ameh, E. A., et al. Global Surgery 2030: Evidence and Solutions for Achieving Health, Welfare, and Economic Development. Lancet. 2015; 386(9993): 569-624.

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7.     Ogbeiwi, O. Theoretical Frameworks for Project Goal-Setting: A Qualitative Case Study of an Organisational Practice in Nigeria. The International Journal of Health Planning and Management. 2022; 37(4): 2328-2344.

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9.     British Society for Surgery of the Hand. Lion Hand Unit | Lilongwe Institute for Orthopaedics and Neurosurgery - Malawi. [Online]  2024. Available at: https://www.bssh.ac.uk/about/lion_hand_unit.aspx [Accessed 1st April 2024].

10. World Orthopaedic Concern UK. Cambodia - the Kadoorie Senior Orthopaedic Fellowship, Children’s Surgical Centre (Csc), Phnom Penh, Cambodia. [Online] (28th October 2019)  2019. Available at: https://wocuk.org/locations/cambodia/ [Accessed 1st April 2024].

11. Cambridge Global Health Partnerships. Global Health Fellowships. [Online]  2024. Available at: https://cambridgeghp.org/get-involved/global-health-fellowships/ [Accessed 1st April 2024].

12. Poole Africa Link. Welcome to Poole Africa Link. [Online] (20th December 2023)  2016. Available at: https://pooleafricalink.org.uk/ [Accessed 1st April 2024].

13. Primary Trauma Care Foundation. Primary Trauma Care Foundation - Home. [Online] (4th October 2022)  2015. Available at: https://www.primarytraumacare.org/ [Accessed 1st April 2024].

14. Mercy Ships. Mercy Ships. [Online] (18th March 2024)  2018. Available at: https://www.mercyships.org.uk/ [Accessed 1st April 2024].

15. Joint Committee on Surgical Training. Out of Programme Experience. [Online]  2024. Available at: https://www.jcst.org/uk-trainees/str-trainees/out-of-programme/out-of-programme-experience/ [Accessed 1st April 2024].

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17. While, R. Health Education England Guidance for Trainees Planning to Volunteer or Work Overseas. [Online] London: Health Education England; 2017. Available at: https://www.hee.nhs.uk/sites/default/files/documents/HEE%20Guidance%20for%20Trainees%20planning%20to%20volunteer%20or%20work%20overseas%20v2%20(Low%20resolution).pdf?fbclid=IwAR0rLuvpbUoQN4ZlzrgBotu552SHNg_HISTmGqlnAsVEMKgkiTaAN51ES4c [Accessed 1st April 2024].

18. Berwin J.T., Brown M., Bucknall V., Bose D., On behalf of the BOTA Committee. Attitudes Towards Orthopaedic Volunteering in Low-Resource Settings. The Bulletin of the Royal College of Surgeons of England. 2020; 102(4): 144-149.

19. Bauer, I. More Harm Than Good? The Questionable Ethics of Medical Volunteering and International Student Placements. Tropical Diseases, Travel Medicine and Vaccines. 2017; 3(1). Available at: https://dx.doi.org/10.1186/s40794-017-0048-y [Accessed 1st April 2024].

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23. All-Party Parliamentary Group on Global Health. Improving Health at Home and Abroad: How Overseas Volunteering from the Nhs Benefits the Uk and the World. [Online] London: All-Party Parliamentary Group on Global Health; 2013. Available at: https://www.thet.org/wp-content/uploads/2017/08/APPG-Report.pdf [Accessed 1st April 2024].

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39. Yeomans, D., Le, G., Pandit, H., Lavy, C. Is Overseas Volunteering Beneficial to the Nhs? The Analysis of Volunteers’ Responses to a Feedback Questionnaire Following Experiences in Low-Income and Middle-Income Countries. BMJ Open. 2017; 7(10): e017517. Available at: https://dx.doi.org/10.1136/bmjopen-2017-017517 [Accessed 1st April 2024].

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