title: The impact of snow on orthopaedic trauma referrals.
abstract: Adverse weather has been shown to increase orthopaedic referrals and place strain on services. This retrospective study undertaken at a teaching hospital concerned referrals between April 2009 and April 2010 comparing days when snow fell to days when it did not. Referrals increased significantly on snow days (to 74.9 per day) in comparison to normal weather days (33.5 per day). During snow days there were significant increases in the number of distal radius and ankle fractures referred but not of fractured necks of femur. Complications during the snow fall period were related to procedures performed outside of the trauma unit with further difficulties related to a lack of operating equipment and implant availability. As a result of our study, we recommend that during periods of heavy snow fall orthopaedic and trauma units should place senior orthopaedic trainees in Accident and Emergency to review patients as a triage service, organise trauma lists related to surgeon specific expertise and avoid sending trauma patients outside the unit for operation.
authors.affiliation: Royal Sussex County Hospital, Brighton, United Kingdom. samwestonsimons@yahoo.co.uk
authors.forename: John
authors.initials: J
authors.lastname: Weston-Simons
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Jack
authors.forename: Cyrus
authors.initials: C
authors.lastname: Doctor
authors.forename: Kit
authors.initials: K
authors.lastname: Brogan
authors.forename: Daniel
authors.initials: D
authors.lastname: Reed
authors.forename: David
authors.initials: D
authors.lastname: Ricketts
mesh_terms: D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017598:Efficiency, Organizational; D004739:England / Q000453:epidemiology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000458:organization & administration / Q000706:statistics & numerical data*; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012914:Snow; D014193:Trauma Centers; D014218:Triage / Q000592:standards; D000078329:Workforce