In response to the coronavirus pandemic the British Orthopaedic Association Standards for Trauma and Orthopaedics (BOAST) guidelines advised treating distal radial fractures non-operatively where possible. A cohort was studied retrospectively to assess whether the COVID pandemic lockdown within the UK altered types, the management and complications of paediatric distal radial fractures. The cohort studied comprised of 194 paediatric distal radial fractures in the pre-COVID cohort and 101 fractures in the COVID cohort. There was no significant differences in the type of fractures in the two cohorts. Significantly more high energy injuries were sustained among the COVID cohort than the pre-COVID ( p < 0.001). The COVID cohort had significantly more patients managed in cast ( p < 0.001) and significantly more managed with K-wire fixation ( p = 0.049). The COVID cohort had significantly more complications ( p = 0.016) at minimum 10-month follow-up. The results suggest that treatment of paediatric distal radial fractures during lockdown was too conservative and subsequent complications may put additional strain on orthopaedic services. Level of evidence: IV

Background: Thyroid surgery is the mainstay of the treatment of surgical goiters. Treatment modalities for the surgical management of goiter include lobectomy, sub-total thyroidectomy, near-total thyroidectomy and total thyroidectomy. Aim of Study: To compare current surgical management of thyroid diseases in Assuit University Hospital with management guidelines, planning for improving our management of thyroid diseases and correct obstacles to achieve reduction in the morbidity and mortality result from thyroid diseases. Patients and Methods: Our study included 60 patients who were admitted to General Surgery Department with any thyroid disease during a period of six months and managed surgically. All patients had neck ultrasound and FNAC was done for suspicious cases for malignancy. Benign solitary nodular goiter was managed by unilateral lobectomy and isthmusectomy. MNG was managed by total and sub-total throidectomy. Malignant goiter was managed according to cytology with total thyroidectomy being done for most cases. Controlled toxic goiter was managed by total or sub-total thyroidectomy. All cases were subjected to pre-and postoperative layrngoscopic examination for assessement of vocal cord mobility. Post-operative histopathology is amust in all cases. Results: Mean age of the studied patients was 39.18 ± 11.75 years with range between 15 and 63 years. Out of 60 patients, 49 (81.7%) patients were females and 11 (18.3%) patients were males. 17 (28.3%) of the studied had toxic manifestations and 15 (25%) patients were on anti-thyroid medications. Iodine deficiency was noticed in 9 (15%) patients while 7 (11.7%) patients had endemic goiter. Out of the studied patients, 5 (8.3%) patients had family history of thyroid disease. Unilobar enlargement presented in 12 (20%) patients while 48 (80%) patients had Bilobar thyroid enlargement. Diffuse goiter presented in 4 (6.7%) patients and nodular goiter in 56 (93.3%) patients, 13 (21.7%) solit all patients were subjected to thyroid function tests (TSH, free T3 and T4) before and after thyroidectomy. It was noticed that there were significant improvement in level of TSH, free T3 and free T4 after thyroidectomy (p<0.05).