Trauma & Orthopaedics

If you're an emergency physician practicing in the UK you may be a bit surprised to hear about a trial published this week looking at the use of open reduction and internal fixation of rib fractures, and more specifically flail chests. Surgical management of rib fractures is something that took place 40-60 years ago, but in the modern world it's arguably not routine.

So the dogma increasingly seems to be is that judicious prehospital fluid resuscitation is a bad thing.

httpv://www.youtube.com/watch?v=Iwuy4hHO3YQ

I recently had a bit of fun at the Telford trauma conference talking about the top 10 papers of 2012 and in passing mentioned the #dogmalysis of ATLS shock categories published in Resuscitation last year (with thanks to Cliff Reid for blogging on it). Anyway, the idea of clinical signs as predictors of outcome is very topical at the moment as those of us in UK trauma centres are being measured and funded against our ability of identifying all patients with an ISS of 15 within 5 minutes of arrival..., it's a bit of a problem and something worthy of a complete blog post later.

OK folks, a really quick post 5 days...., yes 5 days before I am due to speak in Telford at the 2013 Trauma Care conference. I've been given the topic of 'The top ten trauma papers of 2012-present and I'm talking in the emergency medicine stream.