Acute hot joint assessment and management
An acute hot swollen joint is a common presentation in the emergency department and may present as a diagnostic dilemma for many clinicians. The aim of this article is to provide a straightforward approach to assessing a patient with an acutely swollen joint. This includes taking a focused history, general and specific examinations, investigations, considering important differentials, and treatment modalities. Delays in the diagnosis and treatment of septic arthritis can have catastrophic results  including joint destruction, bacteraemia, septic shock and death. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 19, 2023 Category: Surgery Authors: Laxmi Venkatachalam, Charlotte Lewis Tags: General principles and paediatrics Source Type: research

Principles of bone healing
This article outlines the biology of bone and fracture healing. The complex mechanisms involved in fracture healing can be broadly classified into indirect and direct bone healing. The most common mechanism is indirect bone healing as it does not need rigidly stable conditions or anatomical reduction, but occurs through a complex biological pathway of acute inflammation and recruitment of mesenchymal stem cells to generate a primary cartilaginous callus. Bone healing occurs through endochondral ossification and intramembranous bone formation. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 12, 2023 Category: Surgery Authors: Suresh Kondi, Sushmith R. Gowda Tags: General principles and paediatrics Source Type: research

Pathological fractures for the MRCS
Pathological fractures occur within abnormal bone often at normal physiological load. Whilst uncommon, they should always be considered with low energy or atraumatic fractures and in those with signs, symptoms or a past medical history of malignancy. Early recognition is important as pathological fractures require investigation regarding their underlying cause before a decision regarding optimal management can be made. Elements within the patient history, examination and plane film radiographic imaging can alert clinicians to a potential pathological fracture. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 11, 2023 Category: Surgery Authors: Benjamin Woolner, Charmilie Chandrakumar, Bhavisha A. Patel, Luke W. Harries, Jasmeet Jhaj, Andrew Tasker Tags: General principles and paediatrics Source Type: research

Common paediatric congenital deformities
Congenital paediatric deformities are an extensive topic, with a diverse occurrence and presentation in orthopaedic practice. Some conditions, such as hip dysplasia and clubfeet, are more common, and may be encountered routinely in clinic. However, a large majority of anomalies are comparatively rare. Their association with medical conditions, variable presentation and multidisciplinary approach in management, makes the topic essential knowledge in orthopaedic practice. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 9, 2023 Category: Surgery Authors: Taushaba Hossain, Alexander Aarvold Tags: General principles and paediatrics Source Type: research

The orthopaedic trauma list – principles and planning
The planning and coordination of an orthopaedic trauma list is a core skill. It is applicable to all grades of trainee and senior staff, as to be successful, it requires input and coordination by all members of the clinical team. There are several, predictable domains of patient care that must be considered and balanced when constructing a trauma list. These are broad and are only in part clinical, as logistical and philosophical elements also play a role. We outline the issues impacting on trauma list construction and coordination and provide a framework to base decision making on. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 8, 2023 Category: Surgery Authors: Will Eardley, Sarah Nellis, Tim Meek Tags: General principles and paediatrics Source Type: research

Non-accidental injuries in children
Non-accidental injury (NAI) poses a complex problem to healthcare professionals around the world. There are no specific signs or symptoms that directly correlate with the inflicted injury, but diagnosis is based on high index of suspicion in cases where there is confounding history, disproportionate injury, radiological findings, together with social circumstances. The age of the child is a known risk factor, with the younger child being more likely to suffer recurrent and severe trauma, resulting in increased morbidity and mortality. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 8, 2023 Category: Surgery Authors: Taushaba Hossain, Matthew Barry Tags: General principles and paediatrics Source Type: research

Necrotizing fasciitis
(NF) is a rare life-threatening skin and soft tissue infection. Most commonly the result of trauma, it rapidly spreads through the fascial planes and causes necrosis of the subcutaneous tissues. The disease is classified into different types depending on the underlying bacteria responsible, with Group A streptococcus reported as the most common organism found. Reaching a diagnosis of NF is often challenging due to its non-specific signs and symptoms. A delay to recognition and treatment significantly increases the risk of mortality. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 8, 2023 Category: Surgery Authors: Charlotte Wray, Omar-Adam Salim, Daniel Marsland Tags: General principles and paediatrics Source Type: research

Paediatric forearm fractures, evidence update and BOAST guidelines
Forearm and wrist fractures are the most common fractures in children. Compared with adults, children have different fracture patterns, and their bones have better remodelling potential. Despite the frequency of injuries, until recently there has been little evidence to guide treatment, with considerable variation in practice. The “British Orthopaedic Association Standard for Trauma (BOAST): Early Management of Paediatric Forearm Fractures” has provided the orthopaedic community with coherent standards for management of angulated but not off-ended fractures. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 8, 2023 Category: Surgery Authors: Ha Phuong Do Le, Daniel C. Perry Tags: General principles and paediatrics Source Type: research

Tourniquet use in trauma and orthopaedics, how and when: current evidence
This article is designed to review the recently published papers to provide clinical guidance for the safe use of the techniques intraoperatively to minimize the possible complications. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 8, 2023 Category: Surgery Authors: Farouk Hamad, Nigel Rossiter Tags: General principles and paediatrics Source Type: research

Principles of consent in trauma and orthopaedics
Consent is one of the essential elements of daily practice for clinicians working in Trauma and Orthopaedics. Autonomy is the right of competent adults to make informed decisions about their care. GMC guidance has placed a professional burden on surgeons to provide informed decision  making. The Montgomery v Lanarkshire Health Board (2015) case set a precedent that has driven the modernization of consenting practice, raising the status of shared decision making from guidance to legal requirement. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 8, 2023 Category: Surgery Authors: Christopher Wilson, Qamar Mustafa, Tim Crook Tags: General principles and paediatrics Source Type: research

Contents
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 1, 2023 Category: Surgery Source Type: research

Editorial Board
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - September 1, 2023 Category: Surgery Source Type: research

Intestinal and multivisceral transplantation
can be a lifesaving treatment for patients with complications from the treatment of intestinal failure. However, the indications for this highly specialized treatment are broadening and include other such indications as patients with acute abdominal vascular catastrophes as well as patients with previously unresectable benign intra-abdominal tumours. Since the first successful multivisceral transplant in the late 1980s, the field has expanded and more than 4000 transplants have taken place worldwide and outcomes continue to improve. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - August 19, 2023 Category: Surgery Authors: Neil Russell Tags: Transplantation Source Type: research

Liver transplantation
Major advances have been made in the field of liver transplantation over the last 50 years. Survival rates are now approximately 90% thanks to improved immunosuppression regimens following the introduction of calcineurin inhibitors, the development of novel organ preservation strategies and enhanced perioperative care. The spectrum of disease now definitively treated with liver transplantation has also grown to  encompass not only acute and chronic liver disease but also hepatic malignancies. Early referral to specialist centres affords better outcomes for potential recipients and has prompted the development of scoring s...
Source: Surgery (Medicine Publishing) - August 19, 2023 Category: Surgery Authors: S.G. Farid Tags: Transplantation Source Type: research

The immunology of organ transplantation
Transplantation is the gold standard treatment for many patients with end-stage organ failure. In addition to the medical and surgical challenges in organ transplantation, the major biological barrier is immunological. This barrier may lead to graft rejection and loss. An understanding of transplant immunology is essential in order to care for transplant recipients. The aims of this article are to describe commonly used immunological terms, the immunology of graft rejection, the different types of rejection, and how this process may be prevented with immunosuppressive therapy. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - August 18, 2023 Category: Surgery Authors: Benedict L. Phillips, Chris Callaghan Tags: Basic science Source Type: research