The coronavirus restrictions in 2020 have seen an increase in bicycle use, and an influx of traffic on cycle paths in Western Australia. Paediatric bicycle related emergency department presentations in Perth, Western Australia, increased by over 40% during March to June 2020 compared to 2019 rates. During the same time, paediatric admissions from the emergency department decreased by 24.3%, but admissions for injuries related to bicycle use increased by nearly 50%.

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Case: A 15-year-old adolescent girl presented with a complete Achilles tendon rupture from playing netball, which was diagnosed 6 weeks later. Unfortunately, there was a significant deficit of 92 mm, and an allograft reconstruction was required to bridge the gap. Conclusion:Achilles tendon ruptures are rare in children and adolescents without a penetrating injury, but the diagnosis must not be missed. Achilles tendon ruptures should be considered in children with acute-onset ankle pain during running, jumping, or sudden dorsiflexion of the ankle. Tendon transfers and allograft may be required after rupture and retraction has occurred in subacute or chronic injuries.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B978).

Background: There are very few studies in the literature focusing on neonatal burns, and to our knowledge this is the largest study on this topic. Methods: A retrospective review was conducted over a 10-year period from 2010 to 2020 to investigate the incidence, mechanisms involved and outcomes for burn injuries in neonates in Western Australia. This study included children aged 4 weeks or younger who sustained a burns injury requiring admission to hospital or during their hospital admission. Premature infants who sustained burns during a hospital admission in the neonatal intensive care unit and were under 4 weeks corrected age were also included. Short-term outcomes of burn injuries included infection and need for surgery, and the long-term outcomes included scarring and requirement for laser therapy. Results: Over the 10-year period, 30 burn injuries were sustained by 27 neonates. Thirteen (43.3%) of these burns occurred at home or in the community, and 17 (56.7%) occurred in hospital. Scalds (n = 4) and sunburn (n = 4) were the most common mechanism in the community, while chemical (n = 12) burns including extravasation injuries were the most common sustained in hospital. No neonates required theatre for skin grafting or laser therapy for scarring. There were no infected burns in the cohort. Time to healing ranged from 2 to 62 days with a mean of 12.1 days. Conclusion: Outcomes for burns sustained in the neonatal period in Western Australia are generally positive, and have not been associated with infection and have low rates of scarring.

Background: Meier-Gorlin syndrome (MGS) is a rare genetic disorder associated with urogenital abnormalities, including hypoplastic labia and uterine hypoplasia. In the very few cases published in the literature, there have been instances of these reproductive abnormalities affecting some, but not all, women with the disorder. There have been no previously published pelvic laparoscopic images from a woman with MGS. Case: A 32-year-old nulliparous woman with MGS underwent an emergency laparoscopy for a hemoperitoneum caused by a ruptured cyst. Results: Unfortunately, due to undiagnosed uterine hypoplasia, a uterine perforation occurred from the uterine manipulator. Other features of her anatomy included short clubbed fallopian tubes and a bowl-shaped pelvis. Conclusions: The intraoperative images included in this article provide insight into a rare disorder and highlight the importance of considering uterine hypoplasia prior to uterine instrumentation. Laparoscopic or ultrasound guidance should be used for intrauterine procedures for women with unknown or suspected uterine hypoplasia. ( J GYNECOL SURG 36:161