Density-dependence and environmental variability have stage-specific influences on European grayling growth.

Fish somatic growth is indeterminate and can be influenced by a range of abiotic and biotic variables. With climate change forecast to increase the frequency of warming and unusual discharge events, it is thus important to understand how these variables currently influence somatic growth and how that might differ for specific age-classes and/ or life stages. Here, we used a 17-year dataset from a chalk stream in southern England to identify the abiotic and biotic influences on the growth of juvenile, sub-adult and adult life stages of European grayling (Thymallus thymallus), a cold-water riverine salmonid. The results revealed that interannual variations in grayling growth were well described by annual- and site-specific abiotic and biotic explanatory variables. We found divergent responses between life stages to increased temperature and unusual discharge during the main growth period with, for example, elevated temperatures related to increased juvenile growth but reduced sub-adult growth, and high discharge events related to increased sub-adult growth yet reduced juvenile growth. Conversely, stage-specific grayling abundance negatively influenced growth at each life stage, though only juvenile growth was impacted by the abundance of a competitor species, brown trout (Salmo trutta). These results emphasise the merits of testing a wide range of environmental and biological explanatory variables on fish growth, and across life stages. They also reveal the importance of maintaining high habitat heterogeneity in rivers to ensure all life stages can reduce their competitive interactions and have access to adequate flow and thermal refugia during periods of elevated environmental stress.

Primary ankle arthrodesis for neglected open Weber B ankle fracture dislocation.

Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described.

Inter- and intra-observer reliability of a smartphone application for measuring hallux valgus angles.

BACKGROUND: Measurement of radiological angles can be useful in the planning of the management of patients with hallux valgus. A smartphone application offers an alternative way of measuring these angles in a clinic setting. We compared the reliability (inter- and intra-observer) of this method to the use of PACS. METHODS: Radiographs of 30 feet from new patients referred with hallux valgus were examined and angles (HVA, IMA, and DMAA) recorded using the smartphone application and PACS. RESULTS: The smartphone application provided good inter-observer reliability for HVA and IMA (r=0.93 and r=0.79 respectively). Intra-observer reliability for HVA and IMA was also found to be good (r=0.93-0.97 r=0.82-0.93 respectively). The inter- and intra-observer reliability for using this method to measure DMAA fell below useful levels (r<0.60 in each case). CONCLUSIONS: This smartphone application provides a reliable method to measure HVA and IMA but we would not recommend it to measure DMAA.

Large Osteochondral Fracture in a Patient with Bilateral Bicondylar Osteochondritis Dissecans and Spondyloepiphyseal Dysplasia Tarda.

We report a case of a large osteochondral fracture in a patient with bicondylar, bilateral osteochondritis dissecans and spondyloepiphyseal dysplasia tarda.