Traumatic open brachial plexus injuries: The importance of interdisciplinary collaboration.

Open traumatic brachial plexus injuries are rare, yet can be life threatening and require rapid clinic assessment. Early interdisciplinary collaboration is critical to achieve superior patient outcomes. This case of a 24-year-old female of a traumatic neck injury with contralateral brachial plexus injury demonstrates the limitations of early clinical assessment due to the potential for haemodynamic instability and highlights the priority of patient stabilisation. Early and active interdisciplinary collaboration in this case demonstrates its importance in accurate diagnosis and timely intervention to achieve better patient outcomes. As published in recent guidelines, this report shows the importance of early interdisciplinary involvement following stabilisation and resuscitation of the patient.

Saving time in the fracture clinic: 2 weeks post-operative plain films following open reduction and internal fixation of distal radius fractures do not affect management.

INTRODUCTION: Distal radius fractures represent up to one in every sixth treated fracture. The majority of these are intra-articular and require operative management. Many recent studies advocate for the use of volar plating fixation. Following fixation, most patients attend the fracture clinic at 2 and 6 weeks post-operatively and may get repeat imaging at both visits, resulting in longer wait times and repeat exposure to radiation. Revision surgery is however rarely performed in the 2- to 6-week period, raising the question of the necessity of plain film at 2 weeks. AIM: Improve patient satisfaction in the fracture clinic by reducing wait time in fracture clinic and limiting exposure to radiation. METHOD: The number of distal radius open reduction and internal fixation (ORIF) over a 12-month period was retrieved using theatre logbooks. Patient details were used to check whether a plain film radiograph had been performed 2 weeks post-operatively. Subsequently, patients' records were used to determine if revision surgery was performed or planned. RESULTS: In total, 123 distal radius ORIF were performed between January 2018 and January 2019. Two-week check radiographs were performed for 82 patients (67%). One patient (0.8%) underwent revision surgery following review of intra-operative imaging. No patients underwent revision ORIF following 2-week plain film. CONCLUSION: Repeat imaging at 2 weeks following distal radius ORIF did not change management of distal radius fractures in this study. Therefore, our data suggests 2-week plain films should not routinely be ordered for these patients which will reduce wait time and exposure to radiation.