BOFAS News & Events

The aim is to give Overseas Trainee Orthopaedic Surgeons a solid grounding in the principles and the decision making in Foot & Ankle Surgery.

There is an emphasis on clinical examination of cases, small group discussions and learning surgical approaches in the cadaver lab.

This is the first course BOFAS is running in UAE and the aim is to expand the Foot and Ankle education and training in the Middle East and Gulf area.

Venue - Le Meridien, Dubai, United Arab Emirates

These courses are aimed at Higher Surgical Trainees / ST3 onwards and are designed to teach the core of Foot and Ankle surgery in an informal and interactive environment. The emphasis is on clinical examination cases, discussion groups and typical day-to-day clinic scenarios. Although not an exam preparation course, content is taught to the standard expected in the FRCS(Tr & Orth) exam; that of a day-one non-specialist orthopaedic consultant. Applications will open on 1st September 2023.

Venue - Taunton (TBC)

https://pubmed.ncbi.nlm.nih.gov/25868938/

The survey completed by 181 members showed wide variations in practice, with patients being managed in plaster cast alone (13%), plaster cast followed by orthoses management (68%), and orthoses alone (19%). Within these categories, further variation existed regarding the individual rehabilitation facets, such as the length of time worn, the foot position within them and weight-bearing status.

BOFAS Poster 2018

This survey provides a consensus on determining the stability of supination external rotation ankle fractures. Patients with un-displaced SER ankle injury who have not walked prior to presentation should undergo standing radiographs regardless of the presence or absence of medial tenderness, at approximately 1 week from injury. Medial tenderness does not determine stability.

https://pubmed.ncbi.nlm.nih.gov/32405212/

A 10 question online survey was sent to UK surgeons and AHPs 2019 with 117 surgeons and 55 AHPs responding. More than half of respondents (57%) reported that not all patients were referred for post-operative rehabilitation. There was a wide variation in the time point at which patients were instructed to weight bear (2 weeks to >12-weeks). Non-union was a concern of early mobilisation. Qualitative themes identified were: treatment tailored to individual patients, lack of knowledge about the patient journey, treatment tailored to surgeon preferences, lack of a pathway, variation in practice. There is a wide variation in the post-op rehabilitation of patients undergoing this surgery in the UK, with a lack of published research in this area.

https://pubmed.ncbi.nlm.nih.gov/33573901/

At the BOA and BOFAS meetings 315 questionnaires were completed. For Weber B injuries, there was consensus with minimally displaced and grossly displaced fractures being treated conservatively and operatively respectively. For Posterior Malleolus injuries, there was variation in practice between Foot and Ankle specialists and their non-Foot and Ankle colleagues. Computed tomography was used more by specialists (97.50 vs 69.79%) and these injuries were more likely to be treated operatively across the board.

https://pubmed.ncbi.nlm.nih.gov/33946003/

With the support of the BOFAS and the Orthopaedic Trauma Society an online 10-question survey was distributed. Over one third (69/183, 37.7%) of surgeons reported they routinely remove metalwork following Lisfranc injury fixation at a median time of 6 months post fixation (interquartile range 4-10). The two common reasons for removal of metalwork were 'to optimise physiological function' and 'to reduce the risk of broken metalwork and risk of making subsequent surgery more difficult' (55/78 responses, 70.5%). Over two thirds of survey respondents (126/184, 68.5%) expressed interest to participate in a randomised controlled trial to compare outcomes of metalwork retention versus removal following Lisfranc injury fixation.

Survey reporting highest proportion of surgeons seeing 4 to 6 cases per year with xrays and MRI or CT commonly utilised for investigation. Treatment options vary with the Smillie disease stages. Many treatments offered from the options of conservative, salvage, osteotomy, implant or destructive. Cheilectomy and osteotomy being the most prevalent. This survey lead onto further work and a publication:

Hoggett L, Nanavati N, Cowden J, Chadwick C, Blundell C, Davies H, Davies MB. Foot (Edinb). A new classification for Freiberg's disease. 2021 Dec 24;51:101901.

https://pubmed.ncbi.nlm.nih.gov/35259580/