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Purpose: With the growing technical options of power transmission and energy-saving options in electric drives, the number of E-bike-related accidents especially in an elderly population has increased. The aim of the current study was to compare if the increased velocity in comparison to conventional bikes translates into different injury patterns in the cranio-cervical and head region., Methods: A retrospective cohort study was performed in patients admitted to our level one trauma center between 2009 and 2019 after being involved in an accident with either an E-bike, bicycle, or motorcycle and suffered cranio-cervical or traumatic brain injury., Outcomes: cranio-cervical/intracranial injury pattern. Data interpretation was conducted in an interdisciplinary approach., Results: From 3292 patients treated in this period, we included 1068 patients. E-bikers were significantly older than bicyclists (or motorcyclists) and lay between the other two groups in terms of helmet use. Overall injury patterns of E-bikers resembled those found in motorcyclists rather than in bicyclists. E-bikers had a higher incidence of different cerebral bleedings, especially if no helmet was worn. Helmet protection of E-bikers resulted in a comparable frequency of intracranial bleeding to the helmeted bicyclists., Conclusion: The overall pattern of head and cervical injuries in E-bikers resembles more to that of motorcyclists than that of bicyclists. As they are used by a more senior population, multiple risk factors apply in terms of complications and secondary intracranial bleeding. Our study suggests that preventive measures should be reinforced, i.e., use of helmets to prevent from intracranial injury., (© 2024. The Author(s).)

Background: Have you ever been in the trenches of a complicated study only to be interrupted by a not-so urgent phone-call? We were, repeatedly- unfortunately., Purpose: To increase productivity of radiologists by quantifying the main source of interruptions (phone-calls) to the workflow of radiologists, and too assess the implemented solution., Materials and Methods: To filter calls to the radiology consultant on duty, we introduced an automatic voicemail and custom call redirection system. Thus, instead of directly speaking with radiology consultants, clinicians were to first categorize their request and dial accordingly: 1. Inpatient requests, 2. Outpatient requests, 3. Directly speak with the consultant radiologist. Inpatient requests (1) and outpatient requests (2) were forwarded to MRI technologists or clerks, respectively. Calls were monitored in 15-minute increments continuously for an entire year (March 2022 until and including March 2023). Subsequently, both the frequency and category of requests were assessed., Results: 4803 calls were recorded in total: 3122 (65 %) were forwarded to a radiologist on duty. 870 (18.11 %) concerned inpatients, 274 (5.70 %) outpatients, 430 (8.95 %) dialed the wrong number, 107 (2.23 %) made no decision. Throughout the entire year the percentage of successfully avoided interruptions was relatively stable and fluctuated between low to high 30 % range (Mean per month 35 %, Median per month 34.45 %)., Conclusions: This is the first analysis of phone-call interruptions to consultant radiologists in an imaging department for 12 continuous months. More than 35 % of requests did not require the input of a specialist trained radiologist. Hence, installing an automated voicemail and custom call redirection system is a sustainable and simple solution to reduce phone-call interruptions by on average 35 % in radiology departments. This solution was well accepted by referring clinicians. The installation required a one-time investment of only 2h and did not cost any money., Competing Interests: Declaration of competing interest None of the authors has any conflict of interest to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Hallux extensus is a persistent dorsiflexion of the first metatarsophalangeal joint. Apart from many other causes, it can also be caused by contracture of the extensor hallucis longus muscle, in our case resulting from surgical treatment of crural fracture. The authors present the case of a 17-year-old soccer player who sustained a fracture of both shin and calf bone during a soccer match and underwent surgical treatment with intramedullary nailing. While compartment syndrome wasn't observed, a postoperative complication in the form of progressive development of a dynamic type of hallux extensus was reported. The reason behind this complication was later found to be the interaction of the osteosynthesis material with the extensor hallucis longus muscle, which led to its scarring and shortening. A Z-lengthening of the musculus extensor hallucis longus tendon was indicated and performed with a good clinical outcome. During surgery, an anatomical variation in the course of the extensor hallucis longus was observed, which had to be taken into account to achieve a successful surgical outcome. Key words: cock-up big toe deformity, musculus extensor hallucis longus contracture, Z-lengthening tenotomy, crural fracture complication.