Archimedes July 2021

BMJ talk medicine

It’s the height of summer in the UK and, of course, this makes our thoughts turn to concussion, slipped upper femoral epiphyses and proxy outcomes. (Well, to be honest, I’m not sure it really does... but if you do play out more maybe concussion is more likely and certainly some orthopaedic things are?) SUFE is something we do occasionally see and want to prevent really long term consequences. If one side has slipped though, should the surgical team go in and pin the other in place? (https://adc.bmj.com/content/106/7/715.1) And of course one of the issues with this sort of thing is that the outcomes we really want to see many be many, many years away. Can we use an ‘early warning’, surrogate or proxy for that outcome? And do you know what that even means? (https://adc.bmj.com/content/106/7/715.2) If people, rather than UFEs, slip, then banging heads and getting concussions are not uncommon. Rugby league has introduced a system of head injury assessment to improve the safety of players after such events. But should those young contenders in Academy sides, like other teens, stay away from media screens to reduce the chance of problems after? (https://adc.bmj.com/content/106/7/720) All these questions are addressed, if not answered, this month. And you can throw your own Q&A into the ring too - submit an Archimedes by following our instructions and have fun (in the sun, but with a hat and lots of sunscreen on).