Introduction The development of reporting guidelines over the past 20 years represents a major advance in scholarly publishing with recent evidence showing positive impacts. Whilst over 350 reporting guidelines exist, there are few that are specific to surgery. Here we describe the development of the STROCSS guideline (Strengthening the Reporting of Cohort Studies in Surgery). Methods and analysis We published our protocol apriori. Current guidelines for case series (PROCESS), cohort studies (STROBE) and randomised controlled trials (CONSORT) were analysed to compile a list of items which were used as baseline material for developing a suitable checklist for surgical cohort guidelines. These were then put forward in a Delphi consensus exercise to an expert panel of 74 surgeons and academics via Google Forms. Results The Delphi exercise was completed by 62% (46/74) of the participants. All the items were passed in a single round to create a STROCSS guideline consisting of 17 items. Conclusion We present the STROCSS guideline for surgical cohort, cross-sectional and case-control studies consisting of a 17-item checklist. We hope its use will increase the transparency and reporting quality of such studies. This guideline is also suitable for cross-sectional and case control studies. We encourage authors, reviewers, journal editors and publishers to adopt these guidelines.
Although scaphoid fractures are relatively common encounters in orthopaedic and trauma surgery, the demographics of these injuries are not well studied. The classical teaching in the subject limits scaphoid fractures in the age between ten and 60 years (or 70 years in other sources). The incidence or the prevalence of scaphoid fractures in the elderly population is not focused on and not studied or explored. We reviewed the literature for any available epidemiological studies of scaphoid fractures. We also sought the available data of scaphoid fractures in the elderly population in case series and case reports which have relevant data on the subject. Four epidemiological studies, two case series, and one case report are included. We discuss the available data in these articles and conclude that scaphoid fractures in the elderly, although rare, have been reported. However, there are not enough epidemiological studies to draw figures. Ignorance of this proportion of population could result in missed fractures in the elderly. Therefore, we encourage researchers to carry out epidemiological studies of scaphoid fractures with more focus on this population group.
INTRODUCTIONHip fractures are the most common cause of acute admissions to orthopaedics and in the UK approximately 70,000–75,000 hip fractures occur annually. Hip fractures carry a significant risk of developing a venous thromboembolism. The National Institute for Health and Clinical Excellence (NICE) estimated that the risk of developing a venous thromboembolism in patients with hip fractures who do not receive thromboprophylaxis is 43%. In their recent guidelines, NICE recommended that combined mechanical and pharmacological thromboprophylaxis should be offered to patients undergoing hip fracture surgery and mechanical prophylaxis should be commenced at admission. The aim of this review was to search for available evidence that could support using graduated compression stockings combined with low molecular weight heparin (LMWH) in hip fracture patients.METHODSNICE guidelines and the reference list of the guidance were reviewed and a thorough literature search was performed on main electronic databases (MEDLINE®, Embase™ and the Cochrane Library).RESULTSA literature search was unable to find sufficient evidence to support the use of graduated compression stockings combined with LMWH in hip fracture settings. The guidelines are critically reviewed and the available evidence discussed.CONCLUSIONSThe evidence supporting these recommendations is very limited and there is considerable concern regarding the safety and efficacy of the mechanical devices used in thromboprophylaxis. Further studies are needed urgently before specific guidelines can be agreed confidently for patients with hip fractures.
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