Purpose To assess the ability of volar locked plating to achieve and maintain normal radiographic parameters for articular stepoff, volar tilt, radial inclination, ulnar variance, and radial height in distal radius fractures. Methods We performed a retrospective review of 185 distal radius fractures that underwent volar locked plating with a single plate design over a 5-year period. We reviewed radiographs and recorded measurements for volar tilt, radial inclination, ulnar variance, radial height, and articular stepoff. We used logistic regression to determine the association between return to radiographic standard norms and fracture type. Results At the first and final postoperative follow-up visits, we observed articular congruence less than 2 mm in 92% of fractures at both times. Normal volar tilt (11°) was restored in 46% at the first follow-up and 48% at the final one. Radial inclination (22°) was achieved in 44% at the first follow-up and 43% at the final one, and ulnar variance (01 ± 2 mm) was achieved in 53% at the first follow-up and 53% at the final one. In addition, radial height (14 ± 1mm) was restored in 14% at the first follow-up and 12% at the final one. More complex, intra-articular fractures (AO class B and C and Frykman types 3, 4, 7, and 8) were less likely to be restored to normal radiographic parameters. However, because of the small sample size for some fracture types, it was difficult to discover significant associations between fracture type and radiographic outcome. Conclusions Volar locked plating for distal radius fractures achieved articular stepoff less than 2 mm in most fractures but only restored and maintained normal radiographic measurements for volar tilt, radial inclination, and ulnar variance in 50% of fractures. The ability of volar locked plating to restore and maintain ulnar variance and volar tilt decreased with more complex intra-articular fracture types.

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Many epidemiological and clinical studies in Europe, especially in Eastern Europe and countries in transition, are of poor methodological quality because of lack of background knowledge in clinical epidemiology methods and study designs. The only way to improve the quality of epidemiological studies is to provide adequate undergraduate and/or postgraduate education for the health professionals and allied health professions. To facilitate this process, the European Federation of Neurological Societies (EFNS) Task Force on teaching of clinical epidemiology in Europe was set up in October 2000. Based on analyses of the current teaching and research activities in neuroepidemiology in Europe, this paper describes the Task Force recommendations aimed to improve these activities.An evidence-based approach to the prevention and management of neurological disorders is impossible without robust knowledge on their risk factors, natural history, frequency, outcomes and effective treatment strategies. Many epidemiological and clinical studies in Europe, especially in Eastern Europe and countries in transition, are of poor methodological quality because of the lack of background knowledge in clinical epidemiology methods and study designs. This implies that considerable resources (both human and monetary) are being employed inefficiently. In addition, there is a great need for up-to-date knowledge of the epidemiology of neurological disorders in Europe, including the methods of assessment used in clinical epidemiology. The only way to improve the quality of epidemiological studies is to provide adequate undergraduate and/or postgraduate education for the health professionals and allied health professions. However, before any guidelines can be proposed to improve the training in the neuroepidemiology throughout the Europe, background data on current teaching activities in the field in Europe are needed. To meet these objectives, the European Federation of Neurological Societies (EFNS) Task Force on teaching of clinical epidemiology in Europe was set up in October 2000. The ultimate goal of the Task Force was to develop consensus recommendations aimed to improve training in the field of clinical epidemiology in Europe, with the emphasis on neuroepidemiology and evidence-based practice in neurology. In the context of this report, we consider clinical epidemiology as a part of neuroepidemiology, when the specific neurological disorder is the target. MethodsA self-administered questionnaire was developed by the members of the Task Force and sent with a cover letter to all members of the Task Force and EFNS Scientist Panel on Neuroepidemiology. The questionnaire included 16 questions addressing the following issues: availability and structure of educational programmes in clinical epidemiology for undergraduate and postgraduate students, major topics and structure of the programmes, availability and the need for neurologists with experience in epidemiology, availability and the need for local teaching courses in various fields of Co...

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Audience: This is a practice oral boards case which may be given to emergency medicine (EM) residents at all levels of training and recent EM graduates.Introduction/Background: Thyroid storm is an acute, life-threatening endocrine emergency. It occurs when there is excess circulating thyroid hormone in the bloodstream. It may be precipitated by infection, surgery, pregnancy, trauma, thyroid medication changes, or iodinated contrast exposure. This condition must be quickly identified and treated by EM physicians in order to prevent morbidity and mortality. IThe mortality rate is between 10 and 30% 1 Understanding and treating thyroid storm is included in the 2019 Model of Clinical Practice of Emergency Medicine. 2 Educational Objectives: At the end of this practice oral boards case, the learner will: 1) assess a patient with altered mental status in an oral boards format; 2) review appropriate laboratory testing and diagnostic imaging; 3) identify signs and symptoms of thyroid storm and 4) review appropriate pharmacologic therapies with the proper sequence and timing.