During the last decade, there has been a growing recognition that emotions can be of critical importance for students' learning and cognitive development. The aim of this study was to investigate the self-reported and the observed relationship of: activity-, outcome-, epistemic-, and social emotions' role in students' learning in a clinical interprofessional context. We conducted a focused ethnography study of medical and nursing students' clinical placement in an interprofessional orthopaedic outpatient clinic where the students performed consultations with patients, together. We used content analysis to analyse observational notes and interviews. Two themes were identified. First self-regulated learning with two sub-themes: unexpected incident and reflection. The second theme was cooperative learning with three sub-themes: equality, communication, and role distribution. Participants only reported activating emotions. Negative emotions often occurred when the students together experienced an incongruity between their cognitive capability and the type of task. However, because of the possibility for students to call for a supervisor, the negative activating emotions often, in connection with reflection on the incident, resulted in a positive emotion due to the students' awareness of having acquired new knowledge and capability, and thereby, learning. It is important to be aware of the close interplay between emotions and clinical learning in an interprofessional context. The learning environment must include easy access for supervision.

This study aimed to evaluate whether computed tomography improves the intra- and inter-observer reliability of the Eaton-Glickel classification of trapeziometacarpal joint osteoarthritis. The osteoarthritis of the trapeziometacarpal joint was evaluated with conventional radiographs and computed tomography by two hand surgeons, two registrars and one radiologist in 50 hands of 43 patients (12 male and 31 female) who had a median age of 60 years (46-80). Using plain radiographs, we found a mean intra-observer reliability of 0.54 (0.51-0.74), and the intra-observer reliability was improved to 0.76 (0.64-0.86) using computed tomography. Using plain radiographs, the mean inter-observer reliability was poor at 0.17 (0.04-0.51) and did not improve using computed tomography with a mean inter-observer reliability of 0.22 (0.02-0.38). In particular, the agreement in the distinction between Eaton-Glickel stage III and IV and the evaluation of the degenerative changes in the scaphotrapezio joint was low using computed tomography-scans. The detection of bone cysts on computed tomography was more precise than on plain radiographs.

A 4/5 compartment pedicled vascularised bone graft from the distal radius combined with internal fixation with a Herbert type cannulated screw was used to treat non-union fractures of the proximal pole of the scaphoid in 13 patients. Non-union was identified on plain radiographs alone. Uneventful clinical and radiological healing was achieved in 11 patients. One patient had progressive signs of failure of the fixation of the screw at the proximal pole; the screw was changed and the fracture was stable at reoperation. One patient had a fall postoperatively, radiographs taken at follow-ups showed only partial healing, and he had a bone graft 12 months later. Twelve patients had clinical and radiological union of the fracture, and one patient fibrous healing alone. The technique may improve healing of non-union of fractures of the proximal pole of the scaphoid, but it is still a technical challenge.

In a prospective, randomised trial of 54 hands in 47 patients incisions were randomised to be closed by either absorbable subcuticular (polyglytone 6211, Caprosyn), or non-absorbable interrupted (polybutester, Novafil), sutures after single-portal endoscopic release of the carpal tunnel. There was a significant reduction in pain scores on days 1 and 2 in the patients treated with an absorbable continuous subcuticular suture, and no difference in inflammation or infection. There was no difference in the cosmetic appearance between the two groups after three months.