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Background During the COVID-19 pandemic, there was a need to balance optimum treatment service and the safety of patients and hospital staff. The British Orthopaedic Association recommended a virtual fracture clinic to give the right first-time decision and to minimize patient exposure to disease. This study aimed to evaluate the patients' satisfaction outcomes for the service provided through the virtual fracture clinic. Methodology From January to May 2022, all patients seen by the staff in the Emergency Department (ED) at Queens Burton Hospitals were enrolled in a prospective study. An Excel spreadsheet was provided to both ED personnel and the orthopaedic team for accessibility. Patients were continually added to the spreadsheet, and their cases were reviewed by the on-call consultant to devise treatment plans. A satisfaction questionnaire was collected from patients about their virtual clinic experience as a route to provide treatment service. Results The study comprised 150 patients, with an average age of 40 years. Distal radial fractures represented one-third of the cases. Different modalities of management were offered such as a sling, splint, cast, or referral to physiotherapy. Around 75% of cases were satisfied, understood the advice given over the phone, and were not required to attend the actual clinic. The remaining quarter attended the clinic either for further reassessment by an orthopaedic surgeon or for discussion of their injury as they could not get the full message over the phone due to fast calls, hearing struggles, or just listening to messages. Conclusions The virtual fracture clinic is an effective standalone service that gained around 75% satisfaction in patients' outcome questionnaires. It saved the actual fracture clinic slots and hospital resources. It is recommended to be part of the standard daily practice throughout the United Kingdom.
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PURPOSE: The aim of the current study is to evaluate the functional and radiological outcomes of Malerba osteotomy in comparison to the standardized combined Evans/Medial Displacement Calcaneal Osteotomy (MDCO) in the management of symptomatic flexible pes planus in young adults. METHODS: Prospective randomized control trial included 34 feet (33 patients), 17 cases in each group. Functionally, patients were assessed by AOFAS and FADI scores. Radiographic evaluation included calcaneal pitch, lateral talo-1st metatarsal, AP talo-first metatarsal, AP talo-calcaneal angles, and the talar coverage percentage. RESULTS: Pre-operative and three years follow-up scores and angles were compared between both groups. No statistically significant difference could be detected between both groups (P value 0.87). However, the data showed statistically significant difference in each group when comparing (pre-operative and third year follow-up scores and angles) (P value < 0.001). The mean union rate was eight weeks in Malerba group and nine weeks in Evans/MDCO group. No incidence of nonunion. Complications like calcaneocuboid subluxation, calcaneal anterior process fracture, and lateral column pain were exclusively reported in Evans/MDCO group. CONCLUSION: Malerba osteotomy is a strong valid option for the operative management of flexible pes planus in young adults. Authors recommend Malerba osteotomy in all mild and moderate deformities due to lower complication rate while the combined Evans/MDCO is preferred in severe deformity due to relatively higher corrective power with consideration of possible complications.