Brit J Hosp Med
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Interventional radiology is a subspecialty of radiology that provides a range of minimally invasive diagnostic and therapeutic procedures. It continues to expand and evolve, and has had a marked impact on clinical care in many settings, in some cases averting the need for major surgery and hospital admission. While its role in the setting of trauma is relatively well established, with arterial embolisation a valuable option in the management of haemodynamically unstable patients, it is less prominent in the elective setting. This article provides an overview of emerging applications of interventional radiology in the elective treatment of orthopaedic conditions.
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At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.
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Shared decision making is a collaborative process between clinicians and patients, which aims to select the most suitable management option based on both best available evidence and patient preferences. This article looks at the role of shared decision making in perioperative medicine.
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Major trauma in the UK has changed and can now be thought of as two different diseases: the traditional type of high energy transfer major trauma occurring in younger patients, and low energy transfer major trauma (usually an older person falling on one level). The current NHS trauma system is not well set up to treat low energy transfer major trauma - adapting to the changing disease is the next big challenge.