We celebrate achieving 10k downloads (!!) with a fantastic episode with our first ever trans-Atlantic guest, Dr Yelena Bogdan (@invictaortho), a US Orthopaedic Trauma Surgeon working in New York.

We talk about Yelena's story, Star Wars vs Star Trek (for which Pete did the most research he has done yet for any podcast), and the frank commercialism of baby Yoda. We discuss growing up in Russia and East Germany (Yelena, not us), before moving to the US and pursuing the American dream.

Yelena tells us about Stony Brook medical school followed by navigating the challenges of the US matching scheme, Residency training in Boston and then Fellowship at HSS. 

We consider luck vs opportunity before Pete makes it really weird and brings in time travel (blame Apple News). 

Yelena then tells us about her life as an attending and how her career has evolved and flourished. We talk about her use of twitter as a social and educational tool, her role as a social media ambassador with the AAOS and OTA, and how she maximises her reach and effectiveness. We also review how to stay on the right side of patient confidentiality laws and when social media goes wrong (plus we pity the fool who questions Chip Routt).

We consider Yelena's mentors and the impact they have had on her career and practice, before Pete tells us about his similarities with Matthew McConaughey...

We highlight to Yelena why we think she is such an excellent educator, and the relationship between pre-operative planning, training, and success.

Yelena then tells us about the way she practices evidence-based medicine: the journals she reads, her indexing system, and how this has grown into her role curating the evidence resource list for the Orthopaedic Trauma Association.

We finish up talking about the future of trauma care in the USA and compare it with that here in the UK, before rounding up with some excellent take-home points...

...and much much more!

As always, listen out to the end for a musical Easter Egg.

Please subscribe on your podcast player and leave us a rating!

You can also find us on YouTube, LinkedIn, Twitter, Facebook, Instagram
and at www.orthohub.xyz

Twitter:
@orthohubxyz
@kashakhtar
@petebates

We are back in our most dangerous adventure yet- facing off with Prof Tim Briggs!

We talk about the Briggs family history, his medical and surgical training, his appointment to the Royal National Orthopaedic Hospital and establishing the renowned Bone Tumour Unit. We discuss his time as Medical Director and his transition from orthopaedic surgeon to one of the most influential people in healthcare.

This wide-ranging conversation also covers the development and principles of GIRFT (Getting It Right the First Time), what are Integrated Care Systems (ICS) and what this all means for our profession.

We also talk about some of the challenges and concerns with these initiatives, and we finish up with the future of orthopaedics...

and much much more!

Please subscribe on your podcast player and leave us a rating!

You can also find us on YouTube, LinkedIn, Twitter, Facebook, Instagram
and at www.orthohub.xyz

Twitter:
@orthohubxyz
@kashakhtar
@petebates

**not just for upper limb surgeons- just give it a listen!!!**

this is quite possibly our best episode yet, from our new recording studio in the heart of Shoreditch.

Bates is back with a vengeance (boy is he...) and kicks us off with one of the most disturbing stories we have ever heard.

Our special guest is Lee Van Rensburg (aka @Gnomelover1970) and the title of the episode soon becomes clear.

We discuss:

• how many Vans in elbows
• kilts vs dresses
• loving gnomes & why Graham Tytherleigh-Strong cannot be trusted with garden ornaments
• the magnificent World of Tanks & QuickyBaby
• an overview of the webinar with Adam Watts & Jorge Orbay
• Jorge Orbay’s glorious case takeaway (link)
• a shoutout to Leda Orthopaedics & their support of education
• proprioception in the anterior capsule!
• the evolution of elbow surgery & how our understanding of elbow injuries has developed
• where are we now in our understanding of elbow trauma?
• the classification of coronoid injuries and similarities with the posterior malleolus
• modern surgical approaches to the elbow
• variations in the management of elbow injuries in different centres
• the value of increased collaboration within Orthopaedics 
• what to do when you’ve fixed a terrible triad and there is still some instability
• algorithms for managing terrible triads & the role of plaster casts...
• critical analysis of the Edinburgh paper on non-operative management of olecranon fractures
• the joyous beauty of EQ5Ds
• radial head fixation vs replacement
• challenges of radial head replacement in young post-traumatic patients 
• the management of elbow trauma in high-energy trauma patients
• how to manage elbow instability 
• instability vs stiffness
• all about Essex-Lopresti injuries and some interesting medical history 
• what does the NON-elbow surgeon do with elbow trauma on call on a weekend?
• is there ever a role for external fixators on the elbow?
• elbow injuries in elite athletes 
• what options are there for young patients with post-traumatic OA?
• the future of elbow surgery
• why sport is bad for you

and much much more!

Please subscribe on your podcast player and leave us a rating!
You can also find us on YouTube, LinkedIn, Twitter, Facebook, Instagram and at www.orthohub.xyz

@kashakhtar
@petebates

This is the second conversation with Mr Prim Achan, Consultant Trauma & Orthopaedic Surgeon, previous ABC Fellow and Training Programme Director for the Percivall Pott rotation.

The topics covered are so universal and widely applicable that this episode will be of interest to all physicians and surgeons alike, from *all* backgrounds and specialities, as well as to *anyone* involved in managing teams. 

We discuss:

• an introduction to medical leadership
• why leadership is a very sensitive topic in medicine
• the role of the Specialist Advisory Committee
• the difference between intent and impact
• who in British Orthopaedics is most like Blofeld?
• what can we learn from the '90s Chicago Bulls?
• different leadership styles
• why leadership in sports is not transferrable to medicine
• what is leadership?
• ability vs credibility
• qualifications in leadership
• leading yourself
• starting leadership roles early in training
• the concept of the Dutch Uncle
• leading a department
• the value of a consultant development programme
• how to truly know yourself
• why Michael Jordan would be a terrible medical leader
• preventing and managing rifts between colleagues
• why Prim refuses to buy crisps in the local tavern
• other great sporting teams
• the biggest problem with medical recruitment
• introduction to shaping a team
• 3 great leaders who were bad people
• and much more!

I really enjoyed this wide-ranging conversation with Mr Prim Achan, Consultant Trauma & Orthopaedic Surgeon, previous ABC Fellow and Training Programme Director for the Percivall Pott rotation.

The topics covered are so universal and widely applicable that this episode will be of interest to all physicians and surgeons alike, from *all* backgrounds and specialities. 

We discuss:

• what factors are needed to build a world-class department
• how to choose a mentor
• how to give meaningful advice to mentees
• the differences between a mentor vs an advisor vs a coach
• our personal experience of fellowships
• 5 things that make a great fellowship
• do you have to do an overseas fellowship?
• should you do 2 fellowships?
• when to leave a fellowship early
• the benefit of travelling fellowships
• and more!

A BUMPER DOUBLE-EDITION episode to help get you through the lockdown!

This unprecedented episode is brought to you by the words "covid", "tsunami", "FAME" and "unprecedented".

We review the impact on Covid-19 on the management of trauma & orthopaedic patients.

We talk about the changes in our day-to-day lives and the impact on our clinical practices.

We review how Orthohub (www.orthohub.xyz) came about at breakneck speed, and look back over the 1st webinar. The initial plan was to provide teaching to our local trainees on the Royal London and Percivall Pott rotations, but this rapidly morphed (due to the beauty of t'internet) to providing free interactive orthopaedic education for all.

We then hone in on the non-operative treatment of orthopaedic trauma and the challenges that arise, including the provision of physio and finding traction equipment nowadays.

We think that orthopaedic surgeons may be more open to non-operative treatment after this covid experience and there may be more equipoise within the orthopaedic community.

Pete gives us some tips on external fixation and optimising this in case it inadvertently becomes the definitive treatment out of necessity. 

We then discuss how not ALL upper limb fractures can be treated conservatively (shoutout to Dinesh Nathwani!) and those that may require surgical intervention.

We detour on to Pete's very sharp lockdown haircut before coming back on track with humerus and elbow fractures, including 'milking' the capitellum.

The importance of operating on neck of femur fractures whenever appropriate is highlighted before we undertake a detailed tour of knee injuries plus pelvis, femoral and tibial fractures.

Pete finally comes out and explains why he loves the FAME trial.

We discuss the difference between non-operative treatment and neglect, and what pitfalls to avoid.

We then talk about the hidden burden of trauma that is likely to be coming our way with delayed presentation during a 2nd wave.

Pete summarises his key lessons that we have learnt so far during Covid-19, and this is very good.

He then lets himself down by displaying his ignorance of social media.

Please follow us on twitter (@orthohubxyz), instagram (orthohubxyz), facebook (orthohubxyz) and subscribe and rate us on YouTube https://www.youtube.com/channel/UCUUB7XYW_rnVz_S--XLD1PQ

Please do also subscribe on to see one / do one on your podcast app and leave us a rating, we need your love!

First the rise of Skywalker, now the rise of Bates.

Pete is back to finish up with round 2 of the management of the bleeding pelvic patient.

We recorded this prior to Covid-19 being on anyone's register and the biggest concerns were Brexit and Storm Dennis. Fortunately, Kash has always practiced social distancing from Pete just to be on the safe side.

We talk about AO and what they do. Pete explains how AO were initially very platey and not very naily and how it developed. He then gives us his travelogue on Leeds.

We discuss the 1st and 2nd line resuscitation of the bleeding pelvic patient and Kash even finds himself pushing for BATES (listen and it will all make sense) but will stick with BASTE out of spite.

We get stuck into clotting, TEG and ROTEM. Pete then goes on to display a hidden v nerdy understanding of Star Wars canon and dismisses Kash's superficial knowledge of the subject in comparison with barely concealed disgust.

Things get slightly high-brow as we discuss 2.5 electrolytes, before reverting to normal and Pete threatens Kash with a baseball bat (joking not joking).

We discuss the decision-making process when deciding whether to take the patient to the angio suite for embolisation, or to the operating theatre for pelvic packing.

We finish up with a chat about the beauty of pelvic binders and what elevates them above external fixators and C-Clamps.

'What could possibly go wrong' we wondered at the time of recording and didn't consider that someone might eat a bat and set off a chain of events that we had never seen in our lifetimes...

Chapter timings:
00:00:00  intro
00:01:02  preface
00:01:48  one more thing
00:02:15  orthohub live webinar
00:02:57  AO
00:05:50  Pete's guide to Leeds
00:06:36  review of 1st line resuscitation of the bleeding pelvic patient
00:07:23  our DNAR policy
00:07:40  2nd phase resuscitation of the bleeding pelvic patient
00:08:27  what is BASTE
00:09:42  B is for blood
00:10:19  clotting, TEG & ROTEM
00:12:58  the pufferfish of death
00:14:10  Pete lets slip his hidden supernerd
00:15:08  A is for Acid-Base
00:15:24  don't drink a bottle of Hydrochloric Acid
00:16:32  T is for temperature (S just doesn't fit here)
00:17:52  E is for electrolytes
00:18:33  Pete threatens to kill Kash (joking not joking)
00:22:33  S is for Surgery!
00:23:46  decision making: angio vs pelvic packing
00:28:57  why binders are (nearly always) better than pelvic ex-fixes
00:31:12  what if embolisation doesn't work
00:32:00. Pete summarises
00:33:56  small talk
00:34:19  how about coronavirus?

We are lucky enough to be joined by two of our paediatric and young adult trauma & orthopaedic surgical colleagues for this episode, Claudia Maizen and Manoj Ramachandran.

Chapter timings:

00:00:00  intro
00:01:10  paediatric orthopaedics at Barts Health
00:02:05  Claudia Amazing
00:03:31  Manoj Ramachandran
00:06:05  the 1st time Kash met Manoj
00:07:46  Manoj sneaks in a plug #orthofastfacts
00:08:38  everyone has a plan until they get punched in the mouth
00:09:21  global healthcare challenges in paediatric orthopaedics
00:10:57  unique positioning of The Royal London Hospital
00:12:05  Mark Paterson- the man and his legacy
00:15:54  story behind the Ghana visits
00:19:41  children are not small adults
00:20:05  logistics of providing paediatric orthopaedic care overseas
00:24:19  kit & saving the world one meniscus at a time
00:25:20  challenges of providing paediatric orthopaedic care overseas
00:29:17  raising funds for the Mark Paterson foundation
00:30:00  getting people involved
00:32:08  plans for future provision of wrap-around paediatric orthopaedic care
00:36:03  application of technology
00:38:10  Commonwealth Foundation / QMUL Scholarships
00:41:19  screening / DDH project in Mongolia
00:42:58  wrap-up

Episode links:

• Claudia Maizen: https://bartskidsbones.weebly.com/claudia-maizen.html
• Manoj Ramachandran: http://manoj.mystrikingly.com; https://www.viz.ai
• everyone has a plan until they get punched in the mouth: https://fewzion.com.au/mike-tyson-everyone-has-a-plan-until-they-get-punched-in-the-mouth/
• Lancet Commission on Global Surgery: 
  • https://www.youtube.com/watch?v=bRf8PbQgjGU
  • https://www.lancetglobalsurgery.org
• Mark Paterson:
  • bio https://livesonline.rcseng.ac.uk/client/en_GB/lives/search/detailnonmodal/ent:$002f$002fSD_ASSET$002f0$002fSD_ASSET:376975/one?qu=%22rcs%3A+E004792%22&rt=false%7C%7C%7CIDENTIFIER%7C%7C%7CResource+Identifier
  • Mark Paterson Travelling Fellowship (supported by BJJ & EFORT) https://www.efort.org/fellowships/introduction/mptf/
• Ghana: https://en.wikipedia.org/wiki/Ghana
• Motec Life: http://www.moteclife.co.uk/?LMCL=sQ1pU0
• Andiamo: delivers a medically effective orthosis within 2 weeks of a person’s need globally https://andiamo.io/about/
• Comnmonwealth Foundation/ QMUL Scholarships: https://www.qmul.ac.uk/scholarships/items/commonwealth-masters-scholarships-low-income-countries.html

We start by talking about the repercussions of doing a podcast.

Pete then gives Kash closure as they discuss everything you could ever possibly want to know about binders (its not as dull as it sounds, honest).

They cover (amongst some other stuff) :

• where does the bleeding come from in pelvic fractures
• the nursery rhyme of the human centipede
• how do binders actually work
• how tight is too tight
• should you use a binder in a vertical shear pelvic fracture
• the implications of open pelvic fractures (v v bad)
• the problems with binders
• when to take binders off.

Chapter timings:
00:04:13  intro to pelvic binders
00:04:49  the evidence for binders
00:05:37  where should a pelvic binder be applied
00:06:33  how tight is too tight
00:07:29  the 3 ways binders work
00:09:25  where does the bleeding come from
00:11:38  soft tissue injuries
00:13:20  central venous pressure in trauma
00:13:45  dramatic pause
00:14:45  the case of the vertical shear pelvic #
00:15:39  Pete didn't have a telly
00:18:05  life-threatening open pelvic fractures
00:23:28  working with David Sellu
00:25:29  the problem with pelvic binders
00:26:28  when to take binders off
00:29:19  final take-home message (yes he does say it again)

We catch up over our Christmases and the challenges of nut roast.

Once we establish that Pete will always be late and no technology will help him, we move on to talk about the time that Pete almost died.

Pete then waxes lyrical about his most favourite thing in the world (protocols), before touching on war, the pre-hospital management of trauma, clotting, transfusions and managing the clot.