Musculoskeletal diseases

A young boy’s painful encounter with a moth playing possum.

John J van Bockxmeer · Jennifer Green

Australia’s first successful hand transplant broke with convention to give back independence and quality of life to an older recipient with several health problems who had lost all four of his extremities.

Karen M Dwyer MB BS, PhD, FRACP · Angela R Webb MB BS, MS, FRACS · Hayley S Furniss MCritCareNursing, PostGradCertPlastic · Katie E Anjou BAppSc, PostGradCertHand · Josephine M Gibbs-Dwyer BAppSc, MOccupTherHandFellowship · David B McCombe MB BS, MD, FRACS · Damien G Grinsell MB BS, FRACS · Gillian F Dickinson BAppSc · Richard A Williams MB BS, PhD, FRCPA · Prudence A Russell MB BS, FRCPA · David A Scott MB BS, PhD, FANZCA · Christopher Baker MB BS, FACD · Simon J Vogrin BAppSci · Robyn G Langham MBBS, PhD, FRACP · Helen I Opdam MBBS, FCICM, FRACP · Wayne A Morrison MD, BS, FRACS

Objective: To assess the use of elective knee arthroscopy procedures for all adults 20 years and older, and for adults with a concomitant diagnosis of osteoarthritis (OA) in Victoria.Design, setting and patients: Retrospective, longitudinal cohort study of 807 030 elective orthopaedic admissions using routinely collected public and private hospital data from 1 July 2000 to 30 June 2009.Main outcome measure: Trends in rates of elective ...

Megan A Bohensky PhD, MPH, BA · Vijaya Sundararajan MD, MPH · Nick Andrianopoulos MB BS, MBiostat · Richard N de Steiger MB BS, FRACS, FAOrthA · Andrew Bucknill MSc, MB BS, FRACS · Christos M Kondogiannis MB BS, FRACS · Geoffrey McColl MB BS, PhD, MEd · Caroline A Brand MB BS, MPH

To the Editor: The recent editorial by Kappagoda poses a much neglected question for the medical profession.1 There is a longstanding unmet need to consider undergraduate and postgraduate training and education in medicine generally as a continuum, with streaming as a natural corollary.2 Of the two papers that reported on the changes to the medical curriculum at the University of Sydney since the introduction of the ...

Thomas K F Taylor

To the Editor: We agree with Taylor and others that Australian medical training is too long.1,2 In 2008, Garling provocatively stated “I know of no other university-based performance qualification that requires such lengthy education and training. The only training period remotely approaching this length of time is that to become a Jesuit priest”.3 One year of medical training could be eliminated by reducing clinical and preclinical training ...

Kerry J Goulston · Kim Oates

To the Editor: In South Australia, the incidence of developmental dysplasia of the hip (DDH) diagnosed at or after 3 months of age was 0.22 per 1000 live births between 1988 and 2003, corresponding to a rate of 4–5 new cases per year. Since September 2009, 34 children have been treated at our institution for DDH diagnosed at 3–18 months of age, which equates to an incidence of 0.7 per 1000 live births in SA. ...

Nicole Williams · Bruce K Foster · Peter J Cundy

Appropriate assessment and management of diabetes-related foot ulcers (DRFUs) is essential to reduce amputation risk. Management requires debridement, wound dressing, pressure off-loading, good glycaemic control and potentially antibiotic therapy and vascular intervention. As a minimum, all DRFUs should be managed by a doctor and a podiatrist and/or wound care nurse. Health professionals unable to provide appropriate care for people with DRFUs should ...

Shan M Bergin BAppSci(Pod), PhD · Joel M Gurr BSc(Pod), MBA · Bernard P Allard MB BS, FRACS(Vasc) · Emma L Holland RN, CDE, MA(Ed) · Mark W Horsley MB BS, FRACS(Ortho) · Maarten C Kamp FRACP, MHA, GAICD · Peter A Lazzarini BAppSci(Pod) · Vanessa L Nube DipAppSci(Pod), MSc(Med) · Ashim K Sinha MB BS, MD, FRACP · Jason T Warnock DipAppSc(Chir), GradCertDiabEd · Jan B Alford RN, MEd(AdEd), CDE · Paul R Wraight MB BS, FRACP, PhD

To the Editor: In their letter, Spencer, Howe and Manolios call for investment in fracture liaison services.1 Our own business plan showed that for an investment of $55 000 to hire a nurse, the dividend is $1.5 million in second surgeries prevented. This plan has failed to impress successive chief executive officers or their finance managers, and for good reason. The obstacle is a financial paradox. If a chief ...

Nikolai Bogduk

The well publicised difficulties encountered in managing the recently exposed failure of breast implants manufactured by Poly Implant Prothèse (PIP) have pushed the issue of device regulation into the spotlight. In this issue of the Journal, we address the issue of device regulation and the role and performance ...

Annette Katelaris