ABSTRACT
BACKGROUND: Tibial spine avulsion fractures (TSAFs) account for approximately 14% of anterior cruciate ligament injuries. This study aims to systematically review the current evidence for the operative management of paediatric TSAFs. METHODS: A search was carried out across four databases: MEDLINE, Embase, Scopus, and Google Scholar. Studies discussing the outcomes of the surgical management of paediatric TSAFs since 2000 were included. RESULTS: Of 38 studies included for review, 13 studies reported outcomes of TSAF patients undergoing screw fixation only, and 12 studies used suture fixation only. In total, 976 patients underwent arthroscopic reduction and internal fixation (ARIF), and 203 patients underwent open reduction and internal fixation (ORIF). The risk of arthrofibrosis with the use of ARIF (p = 0.45) and screws (p = 0.74) for TSAF repair was not significant. There was a significantly increased risk of knee instability (p < 0.0001), reoperation (p = 0.01), and post-operative pain (p = 0.007) with screw fixation compared to sutures. CONCLUSIONS: While the overall benefits of sutures over screws and ARIF over ORIF are unclear, there is clear preference for ARIF and suture fixation for TSAF repair in practice. We recommend large-scale comparative studies to delineate long-term outcomes for various TSAF fixation techniques.
ABSTRACT
Head and neck cancer (HNC) refers to malignancies found in mucosal surfaces anywhere from the paranasal sinuses to the larynx, including the various glands and cavities. Between the years 2016 and 2018, there were about 3900 new cases every year in women and 8600 in men, making it the thirteenth most common cancer in women and fourth most common in men. The aim of our study was to evaluate the amount and type of teaching United Kingdom (UK) medical students receive on HNC, and to assess their current knowledge of these cancers. An online survey distributed via university representatives was responded to by 311 final year medical students from 25 medical schools across the UK. Regarding HNC teaching, 72 students (23.2%) reported receiving no teaching at their medical school. Of the 239 who reported receiving teaching, 169 (54.3%) received it in the format of a non-interactive, large group lecture. A total of 271 respondents (87.1%) believed that medical students at their university would benefit from more teaching on HNC. Based on our sample, there appears to be an overall dissatisfaction and lack of confidence surrounding HNC in the undergraduate curriculum. With its increasing prevalence in the UK, it is vital that red-flag symptoms and referral criteria are understood by the future medical workforce.
Subject(s)
Dental Caries , Head and Neck Neoplasms , Students, Medical , Male , Female , Humans , Curriculum , United KingdomABSTRACT
Most of the current oral and maxillofacial surgery (OMFS) specialty trainees in the United Kingdom (UK) remain as those who first undertook a degree in dentistry. However, OMFS is an increasingly popular career choice amongst 'first degree' medical school graduates. The UK medical school curriculum should reflect this trend by ensuring that there is sufficient teaching and exposure to allow medical students to make informed career choices. The purpose of this study was to evaluate levels of awareness of, exposure to, and teaching on, oral and maxillofacial surgery amongst undergraduate medical students in the UK. An online survey was distributed via university representatives and responded to by 76 final year medical students from 15 medical schools across the United Kingdom. No OMFS-related clinical exposure was reported by 69 respondents throughout their time at medical school. Of the seven who did report exposure, the mean length of that exposure was four days. Sixty-three respondents believed that medical students would benefit from more guidance and information on OMFS. Clinical exposure to OMFS by medical undergraduates is low therefore awareness of the specialty is limited. With many dissatisfied with the OMFS exposure and teaching provided by their medical school it shows that there is no lack of interest in OMFS amongst medical undergraduates, rather a lack of opportunity for them.
