Trauma
KADOORIE CENTRE
FOR CRITICAL CARE
RESEARCH AND
Research & Development
EDUCATION
V O L U M E
OUR RESEARCH
THEMES
7 ,
I S S U E
2
treatments
 Rehabilitation
 Patient / Staff
experience
Ankle Injury
Management
Karsten Dreinhöfer, FFN president, David Keene, Dieu Donné
Niesten, Congress Chair
1
Experience of Hip 1
Fracture
PATH 2
2
Patient and
Relative
Experience
2
SPRAINED
2
Professor Matt
Costa
3
WaLLTR
3
Forthcoming
Meetings
3
Contact Details
4
Selected
References
4
2 0 1 5
Ankle Injury Management - the findings
 Effectiveness of
INSIDE
THIS
ISSUE:
S E P T E M B E R
David Keene was awarded the
Best Oral Presentation on
Fracture Management at the
Fragility Fracture Network (FFN)
Congress in Rotterdam. He was
presenting the results of the
Ankle Injury Management (AIM)
Trial, on behalf of Professor
Keith Willett (Chief Investigator)
and the rest of the AIM Trial
group. The findings will also be
presented by Professor Willett
at the British Orthopaedic
Association and the Orthopaedic
Trauma Association conferences.
Contact: David Keene
Experience of Hip Fracture
Dr Jo Brett (Royal College
Nursing Research Institute,
University of Warwick now at
Oxford Brookes University)
has been awarded a PhD for
her research exploring
patients experience of hip
fracture 3 months after
surgery. She interviewed
patients from Oxford
University Hospitals NHS
Foundation Trust with
support from the staff on the
Trauma Unit. The study is
noteworthy for its high
degree of patient partnership
in the research process.
The study explored the lived
experience of hip fracture in
older people. The findings
present the impact on self,
and the role of biographical
disruption in triggering
feelings of incompetency and
frustration, particularly in
those who had been relatively
active prior to hip fracture.
Participants struggled with
feeling labelled as ‘old’ and
‘disabled’ post hip fracture.
Managing expectations and
building confidence and
competency in selfmanagement could be achieved
through comprehensive
discharge planning initiated
early and the introduction of
key workers could be
considered to co-ordinate
seamless care, from acute care
at the hospital to community
care at home, monitoring all
aspects of patients’ wellbeing.
This could improve
communication and help
patients suffering from hip
fracture to negotiate the
complex care pathway and gain
timely referrals to the GP,
physiotherapists, social workers,
or occupational therapists. An
expansion of existing community
services, such as home visits
from occupational therapists and
physiotherapists, or through
employment of clinical nurse
specialists could also help.
Local staff who supported the
study were Mr Bob Handley
(Orthopaedic Trauma Surgeon),
Debbie Langstaff (Matron), Julie
Wright (Consultant Nurse)
Susanna Symonds (Research
Nurse).
Contact: Jo Brett
jbrett@brookes.ac.uk
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VOLUME
Platelet Rich Plasma in Achilles
Tendon Healing
Path2 is a multi-centre,
randomised trial comparing
Platelet Rich Plasma injection
(PRP) and placebo (imitation)
injection in adults with Achilles
tendon rupture. This study is
now up and running in Oxford
and Leicester and has six
recruits already. It is a
complicated study that requires
blood to be taken and spun in a
centrifuge. In the intervention
group the resulting PRP is then
injected into the ruptured
tendon.
7,
ISSUE
2
MRC-NIHR partnership: EME
Programme.
Contact: Louise Spoors
Patients have so far tolerated
this well and staff in the clinic
setting have been very
supportive. The study is being
taken forward in other NHS
Trusts throughout the UK. The
study is funded through the
The centrifuge used to spin
the blood
Patient and Relative/Carer Experience
Building on Jo Brett’s work post
surgery we are exploring patient
and relative/carer experience of
hip fracture in the early phase of
recovery whilst they are in acute
care. This will involve interviews
and observations with 40 patients
who have experienced hip fracture
and 30 relatives/carers who
support their family member or
friend in a physical or emotional
capacity.
A large group of these patients
have some form of memory loss
and are at risk because they are
often unable to articulate their
needs. In order to ensure we
represent this group observations
will include patients without
capacity to consent as long as they
have a personal consultee who feels
they would not object to taking
part in the study. At all times the
researcher will be aware of
patients’ needs and pick up and act
on cues that they are
uncomfortable with the
researcher’s presence.
data collection in the Trauma setting
and has interviewed four patients so
far.
Contact: Lorena Saletti-Cuesta,
Liz Tutton
This research is supported by the
patient partners, Professor Keith
Willett, Mr Bob Handley, Dr Jo
Brett, Debbie Langstaff, Julie
Wright, Dr Ku Shah, Dr Claire
Pulford, and Dr Shvaita Ralhan.
Lorena Saletti-Cuesta has started
SPRAINED: Synthesising a
clinical Prognostic Rule for
Ankle INjuries in the Emergency
Department
The SPRAINED study aims to
develop a prognostic tool to
predict recovery for ankle sprain
patients presenting to Emergency
Departments (ED) and Minor
Injury Units (MIU).
Dr Lorena Saletti-Cuesta
This study opened to
recruitment in July and already
has 8 sites opened and 186
recruits. Two more sites will
open shortly.
The study Chief Investigator is
Professor Sallie Lamb and study
lead is Dr Mark Williams.
Contact: Mark Williams
SPRAINED team: Daryl Hagan,
Jacqueline Thompson, Mark Williams,
Sallie Lamb, Chris Byrne
VOLUME
7,
ISSUE
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2
Professor Matthew Costa
We are delighted to announce that
Professor Matthew Costa has joined
the team at the Nuffield
Department of Orthopaedic,
Rheumatology and Musculoskeletal
Sciences and is based at the
Kadoorie Centre as Professor of
Orthopaedic Trauma Surgery.
Professor Matthew Costa
Matt brings a wealth of experience
in research and is already setting up
new trials in Oxford. Juul Achten
has joined Matt’s team as Research
Manager Oxford Trauma and
Xavier Griffin as an Academic
Orthopaedic Trauma Surgeon.
Matt’s current studies recruiting at
Oxford are WoLLF Wound
management of the lower limb,
FixDT UK Fixation of Distal Tibia
Fractures and WHITE The World
Hip Trauma Evaluation Study run
from the Warwick Clinical Trials
Unit.
Contact: Matthew Costa
WaLLTR
Measuring Recovery in Open
Lower Limb Fractures
This study is part of a larger
observational assessment of
surgical and functional outcomes
in patients who have sustained
major lower limb fractures.
The aim of this study is the
development of a patient centred
recovery scale for use in lower
limb trauma. The scale is being
constructed and validated in 4 key
phases. The questions were
created following a number of
extremely detailed interviews with
patients who had experienced
similar injuries. These were
subsequently developed after 200
patients across the UK filled in a
long version of the questionnaire.
Oxford, amongst other sites, was
involved in phase 3 of this study
and recruited 50 participants who
had an open tibial fracture.
For phase 3 the participants were
required to complete a
questionnaire at any time point in
their recovery, plus a repeat
questionnaire one week later.
We are now at phase 4 of the
study (prospective validation) and
hope to recruit at least 20
participants who will complete
the questionnaire at 6 time points
over a one year period.
The WaLLTR scale has also been
incorporated within the WOLLF
trial questionnaires so that we do
not miss this important group of
patients.
The Principal Investigator is
Professor Ian Pallister who is
based at Morriston Hospital,
Swansea and the Chief
Investigator at Oxford is
Professor Keith Willett.
Contact: Louise Spoors
Forthcoming Meetings
NIHR Trials in
Musculoskeletal Trauma
Annual Meeting Chair: Matt
Costa, University of Warwick
January 27th 2016, 9.15-16.00
Celebrating Trauma
Research in the Thames
Valley Chair: Andrew
McAndrew, University of Reading
January 13th 2016, 9.00-5.00
Trauma Orthopaedic
Research Collaboration
(TORC) National
multidisciplinary meeting, Chair:
Tim Chesser. Next Meetings:
11th March 2016 at
Southmead Hospital, Bristol
and 23rd September 2016 at
Kadoorie Centre, Oxford
Meeting 11.00 - 14.00.
Injuries and Emergencies
Speciality Group (IESG)
Thames Valley and South Midlands
Clinical Research Network
(TVCRN) Chair: Andrew
McAndrew. Next meetings:
4th December 2015, 1st Floor,
Rivergate House, Newbury
Business Park, London Road,
Newbury, RG14 2PZ, 4th
March 2016, at Milton Keynes
Hospital Lunch 12:30, meeting
13:30-3.00
Research Café Local research
staff meet to share experience
and learn from each other. Chair:
Sally Beer. Next Meetings:
10th November 3.00- 4.30,
Margaret Davidson Room,
Postgrad Centre, JR Hospital
Contact: Louise Spoors or
Kathryn Lewis
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VOLUME
7,
ISSUE
Kadoorie Centre
for Critical Care Research and Education
lynn.hutchings@ndorms.ox.ac.uk
Level 3
david.keene@ndorms.ox.ac.uk
John Radcliffe Hospital
sarah.lamb@ndorms.ox.ac.uk
Oxford
debbie.langstaff@ouh.nhs.uk
OX3 9DU
kathryn.lewis@ouh.nhs.uk
Contact: Chris Bouse
maria.mestre@ouh.nhs.uk
Phone:
lesley.morgan@ndorms.ox.ac.uk
01865 223101
Lorena.saletti-cuesta@ouh.nhs.uk
01865 223103
Fax:
louise.spoors@ouh.nhs.uk
01865 223102
liz.tutton@ouh.nhs.uk
keith.willett@ndorms.ox.ac.uk
www.ouh.nhs.uk/kadoorie/
Email addresses
juul.achten@ndorms.ox.ac.uk
chris.bouse@ouh.nhs.uk
mark.williams@ndorms.ox.ac.uk
julie.wright@ouh.nhs.uk
yuhan.zhang@ouh.nhs.uk
matthew.costa@ndorms.ox.ac.uk
xavier.griffin@ouh.nhs.uk
Selected Recent References
Williams MA, Heine PJ,
Williamson EM, Toye F,
Dritsaki M, Petrou S,
Crossman R, Lall R, Barker KL,
Fairbank J, Harding I, Gardner
A, Slowther AM, Coulson N,
Lamb SE. (2015)
Active Treatment for Idiopathic
Adolescent Scoliosis (ACTIvATeS):
a feasibility study. Health Technol
Assess. Jul;19(55):1-242. doi:
10.3310/hta19550.
Tian M, Gong X, Rath S, Rath
S, Wei J, Yan LL, Lamb SE,
Lindley RI, Sherrington C, Willett
K, Norton R, Norton R. (2015)
Management of hip fractures in older
people in Beijing: a retrospective audit
and comparison with evidence-based
guidelines and practice in the UK.
Osteoporosis International (Epub
ahead of print)
Achten J, Parsons NR, Bruce J,
Petrou S, Tutton E, Willett K,
Lamb SE, Costa ML. (2015)
Protocol for a randomised controlled
trial of standard wound management
versus negative pressure wound
therapy in the treatment of adult
patients with an open fracture of the
lower limb: UK Wound management of
Stayt LC, Seers K, Tutton E. (2015) Open Lower Limb Fractures (UK
Patients’ experiences of technology and
WOLFF). BMJ Open. Sep 22;5
care in adult intensive care. Journal of
(9):e009087. doi: 10.1136/bmjopenAdvanced Nursing, 79(1), 2051-2061 doi: 2015-009087.
10.111/jan.12664
Useful Links
Clinical Research Network: www.crn.nihr.ac.uk/
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences:
www.ndorms.ox.ac.uk
Injury Minimization Programme for Schools (I.M.P.S.): www.impsweb.co.uk
University of Oxford: www.ox.ac.uk
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