Parents use the Internet increasingly for information about their children's medical problems. There is no quality control for medical information content. The goals of our study were to assess Internet awareness by families seen in paediatric orthopaedic outpatients departments and the type, quality and reliability of information available, using clubfoot as an example. Parents accompanying children to the outpatient's clinic were surveyed regarding the use of the Internet for medical information. They were asked about their ability to use the Internet, and whether this helped the consultation. To assess the quality of information available, the search phrases 'clubfoot' and 'club foot' were placed in the five most commonly used World Wide Web search engines. Web sites were evaluated for authorship, content and informational value using our own agreed scoring system, ranging from 0-100 points. Sixty-one percent of the questionnaires were completed, the mothers completed 67%. Eighty-four percent reported access to the Internet. Most found their searches useful and 26% were reminded of questions to ask at consultation. When a search for 'clubfoot' was carried out we found 11% of web sites were affiliated to academic institutions. There was a significant difference when the terms 'clubfoot' or 'club foot' were searched. Twenty-eight percent offered conventional information. Thirty-six percent of web sites were not related to congenital talipes equinovarus. The average information value was 26 points (0-98). Parents frequently use the Internet for information about paediatric orthopaedic consultations, prior to consultation. The quality of clubfoot information on the Internet is variable. The development of academic-based websites should be encouraged, as these offer the most useful information.

Long-term upper limb dysfunction is common following nerve preserving surgery. The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections.

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Out-patient freehand core-needle biopsy can be carried out safely on select patients with head and neck masses, and provides high quality histopathology specimens with high diagnostic utility.

In our institution, patients can be relied on to safely self-assess their nasal injuries to decide if they need ENT review when provided with appropriate information. This reduces the outpatient burden on the ENT department with no deterioration in subjective patient outcomes.

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