Blunt cerebrovascular injury (BCVI) encompasses two distinct clinical entities: traumatic carotid artery injury (TCAI) and traumatic vertebral artery injury (TVAI). The latter is the focus of our review. These are potentially devastating injuries which pose a diagnostic challenge in the acute trauma setting. There is still debate regarding the optimal screening criteria, diagnostic imaging modality and treatment methods. In 2012 the American College of Surgeons proposed criteria for investigating patients with suspected TVAI and subsequent treatment methods, caveated with the statement that evidence is limited and still evolving. Here we review the historical evidence and recent literature relating to these recommendations.

In this cohort of recalcitrant cases, ultrasound scans detected a high proportion of atypical non-insertional plantar fascia disease. This would not be detected without imaging studies, and therefore we recommend the use of ultrasound scanning in cases of recalcitrant plantar heel pain that have failed proper first-line management, in order to confirm the clinical diagnosis and to classify the disease as either insertional or non-insertional plantar fasciopathy (or mixed disease). Only in this way can treatments for this group of patients be systematically evaluated against different disease patterns to determine their effectiveness.

In Trauma and Orthopaedics, a daily Trauma Meeting (TM) occurs, where the previous 24-hour take is discussed and a management plan is decided by the consultant on-take. The post-take ward-round (PTWR) usually follows. In the district general hospital (DGH) where this audit was conducted, clinical incidents and root-cause analysis revealed that the TM/PTWR documentation were suboptimal.We identified gold standards. Variables included clear documentation of PTWR, date/time, consultant on-take, clinician leading the wardround, and management plan. 50 cases were reviewed retrospectively. 72% were seen on PTWR. 47% of these were clearly labeled PTWR. 64% of the cases not seen on PTWR were weekend admissions. Documentation of the previously mentioned fields were also poor.Audit results were presented at the department meeting and a Trauma Meeting/Post-Take Ward Round Proforma was implemented. A prospective re-audit of 50 cases revealed that patients not seen on a PTWR decreased to 18%; 4% of these were weekend admissions. 88% of patients seen had a proforma completed. 18% of all cases did not have a proforma.

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Adult spinal deformity is a complex condition, increasing in prevalence, and occurring in a patient population in which it poses unique challenges. This review provides an overview of adult spinal deformity with a particular focus on its clinical evaluation, radiological assessment and classification, reviewing the current literature and amalgamating this with the authors' clinical experience.