Health professionals have a legal and ethical obligation to obtain a valid consent before any procedure. The aim of this study was to assess the adequacy of consent for treatment of distal radius fractures. It also outlines potential improvements that could be made. A study of patients undergoing treatment for distal radius fracture was undertaken. We analysed the risks and complications recorded on the consent form. The common recorded risks were infection (95.6%), vascular injuries (77.8%), nerve injuries (66.7%) and stiffness (42.2%); 31.1% of the consent forms had abbreviations. Junior doctors who consented the patients performed 6.7% of the procedures. The poor documentation of risks or complications indicates that patients are not given appropriate information to ensure that the consent is valid. Proper documentation and refining of consent forms is mandatory to ensure that all major risks are understood by patients. This could go a long way in preventing litigation.

A n 18-year-old boy was accidentally shot with an airgun by a friend while playing at home. He was seen in the casualty unit at Leeds General Infirmary, Leeds, UK. A penetrating ocular injury, with a traumatic cataract and vitreous haemorrhage, was observed. A complex trans-oculofacial injury was confirmed by a computed tomography scan (fig 1). The risks of infection and lead intoxication were not marked with retained intranasal air pellet, and no further endoscopic exploration was undertaken. A primary ocular surgical repair was performed with a lens aspiration, followed by surgery for retinal detachment. Air weapons are an important cause of serious eye injuries in adolescent boys. A survey by the British Ophthalmic Surveillance Unit raised questions regarding airgun use.1 The UK Government has changed the legislation recently to deal with increasing public concerns over airgun misuse. Despite new legislation, airgun pellets remain a cause of sight-threatening ocular injury. An unusual fracture of the scapular body F ractures of the scapula are infrequent; they constitute 3-5% of all shoulder girdle injuries and 1% of all fractures. Fractures of the scapular body/spine make up 50% of scapular fractures. 1A 36-year-old man fell off a horse and sustained a direct injury to the shoulder. On examination, the patient had a prominence over the inferior angle of the scapula with restricted range of movement of the shoulder, especially protraction and retraction of shoulder. Radiographs revealed an unusual fracture of the body of the scapula with an apex anterior angulation of 40˚on the scapular Y view.Scapulothoracic movement is complex and has six movements: elevation, depression, upward rotation, downward rotation, protraction and retraction and they are an important part of the movements of the shoulder girdle. Alhough most scapular body fractures are treated conservatively, fracture malunion can have adverse mechanical and functional effects on shoulder movement.1 Scapular snapping syndrome is one of the problems that could arise from malunion. Accident and emergency staff need to be aware of these complications and the importance of ordering scapular Y views. These fractures would merit an early orthopaedic referral.

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