1	Edinburgh Orthopaedic Trauma Database C.M. Court-Brown
2	In-patient database In-patients 1988 – 2004 Every admission to Trauma Unit Recorded for previous 24 hour period 08.00 Trauma meeting
3	Out-patient database Out-patients 1990 – 2004 Every patient referred from Emergency or from family physicians Virtually every fracture (few toes missed) Information taken from the ‘blue sheet’. Not always accurate eg: scaphoid fractures
4	In-patient database Information recorded Name Address Hospital number Gender Date of admission Date of birth Age Admitting surgeon Diagnosis Site of injury Type of surgery Implant used Site of injury Mechanism of injury Gustilo grade Admission code Additional code
5	In-patient database - Diagnosis Fracture type Dislocation Soft tissue injury Arthritis Spinal disorder Infection Metabolic problem Neurological Skeletal disorder Primary tumour Secondary tumour Vascular problem Post trauma complication Implant problems
6	In-patient database – Diagnosis Fractures Ankle Medial malleolus 254 Lateral malleolus 255 Bimalleolar 256 Trimalleolar 257 Tibia and fibula Proximal end 334 Proximal shaft 335 Midshaft 336 Distal shaft 337 Distal end 338 Radius Head and neck 314 Shaft 315 Distal end 316 Distal end (articular) 317 Femur Head fracture 265 Neck-undisplaced 266 Neck-displaced 267 Neck-basal 268 Gtr/lesser trochanter 269 Intertrochanteric 270
7	In-patient database – Diagnosis Other diagnoses Arthritis Ankylosing spondylitis 003 Gout 006 Haemophilia 007 Infective - pyogenic 009 Infective – viral 010 Osteoarthritis 014 Pseudogout 016 Psoriasis 017 Reiters syndrome 018 Rheumatoid 019 Metabolic Diabetes 202 Hyperparathyroidism 209 Osteomalacia 212 Rickets 213 Others 215 Trauma complications ARDS 850 MOF 851 DIC/Bleeding 852 Fat embolus 853
8	In-patient database- Diagnosis Site of injury Bone Joint Ligament Muscle/tendon Nerve Nerve plexus Nerve root Connective tissue Calcaneus 001 Carpal bone (not sc/lu) 002 Clavicle 003 Femur 004 Fibula 011 Humerus 014 Lunate 019 Metacarpals 028 Metatarsals 040 Patella 045 Pelvis 046
9	In-patient database Surgical code Soft tissue surgery Joint surgery Fracture surgery Dislocation surgery Amputation surgery Cast application 300 Cast + MUA 301 Skin traction 305 Skeletal traction 306 Open reduction 331 ORIF 333 ORIF and graft 334 ORIF + lig repair 335 ORIF + cement 336 Ex fix 340 Removal int fixation 350 Removal ex fix 351 Compartment monitor 520
10	In patient database Implant code Fracture implant Arthroplasty Hemi-arthroplasty Ligaments Spine Asnis screws 001 AO nails 002 AO screws only 003 AO plate/ screws 004 Herbert screw 011 DHS 022 Grosse Kempf nail 010 K nail 012 Smith Peterson nail 024 Watson Jones nail 028 Zickel nail 030
11	In-patient database Site of injury Home Outside Institution Work related Sports RTA Assault Suicide No injury Amateur football Professional football Occasional football Rugby Cricket Skiing Artificial skiing (Hillend) Running/ Jogging Athletics Martial arts Swimming Motor sport Climbing Other
12	In-patient database Additional codes Stress Pathological Fracture dislocation Osteochondral Non-union Intra-articular Post-implant Mal-union Epiphyseal Admission codes Emergency admission to ITU Emergency admission - A and E Admission via out-patients Admission - other ward/hospital Admission from waiting list Re-admission
13	Out patient Database Name Address Date of Birth Age Gender Date of presentation Injury
14	In-patient database Example Tourist knocked down by slow-moving automobile in central Edinburgh. Sustains a closed fracture of tibia and fibula
15	Example Name Augusto Sarmiento Address Florida, USA Number 007 DoB Secret Compound code 0 Additional code 1(stress) Admission code 6 (interesting referral)
16	Example Primary diagnostic code 341 (Tibia and fibula diaphysis) Secondary diagnostic code 070 (Tibia) Surgical code 932 (Compartment monitor) Surgical code 300 (application of cast) Accident aetiology code 580 (RTA pedestrian)
17	Example Surgical code 301 (closed reduction) Surgical code 300 (application of cast or brace) or Surgical code 010 (Intra-medullary nail)
18	Example Uncomplicated union - 16 weeks No knee pain Full joint mobility Back to work 6 weeks Convert to intramedullary nailing The power of the Edinburgh Database
19	Edinburgh Orthopaedic Trauma Unit Lower limb databases
20	Edinburgh Orthopaedic Trauma Unit Upper limb databases
21	Year 2000 fractures All fractures in 2000 In-patient and out-patient All classified Fracture incidence curves Basic fracture epidemiology
22	Databases All very well But it still comes down to people, interest and enthusiasm