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We’re pleased to announce the official launch of FACT-1, the first study from the Foot & Ankle Collaborative in Trauma (FACT) network.

FACT-1 is a national, multi-centre retrospective collaborative study of talus fractures, led by Mr Ed Gee and badged by BOFAS. It represents the first step in building a sustained, high-quality collaborative research programme in foot and ankle trauma.

All study documentation, onboarding details, and data collection resources are now live: https://www.fact-network.co.uk/projects/fact-1-information/

Why FACT-1?

Talus fractures are uncommon, heterogeneous, and associated with high complication rates. Individual centres rarely see sufficient numbers to draw robust conclusions about optimal management or risk factors for poor outcomes.

FACT-1 aims to change that.

By establishing a national collaborative cohort of talus fractures treated over the past 13 years, FACT-1 will allow a well-powered analysis of:

  • Different management strategies

  • Short- and medium-term complications

  • Patient, injury, and treatment-related risk factors

The ultimate goal is to inform best practice and improve outcomes in this challenging area of foot and ankle trauma.

Study Overview

  • Study type: Multi-centre, retrospective cohort study

  • Population: Adult talus fractures treated between 1 January 2013 and 28 February 2026

  • Platform: DARFI (Database for Atypical and Rare Fractures and Injuries)

  • NIHR status: NIHR Portfolio Database Study (CPMS ID: 63957)

  • Lead: Mr Ed Gee

The full protocol can be viewed and downloaded here: https://www.darfi.net/studies/fact-1/

Study Timeline

  • Data collection: 15 February – 12 June 2026

  • Data cleaning & quality control: 15 June – 17 July 2026

  • Data query resolution deadline: 4 August 2026

  • Data analysis: August – October 2026

  • Initial results presentation: BOFAS 2026, Cardiff (4–6 November 2026)

  • Manuscript write-up & submission: November 2026 – January 2027

Getting Involved

Step 1: Check Your Trust’s DARFI Status

To contribute data, your NHS Trust must be a DARFI-registered (green-lit) site.

Once onboarded, your Trust can participate in all current and future DARFI studies without further local R&I approvals.

Step 2: Identify Eligible Patients

Work with your audit, research, consultants, and business intelligence teams to identify patients using the recommended codes, including:

  • ICD-10: S92.1

  • OPCS-4: W20.2 ± Z84.*, W24.2, W22.2
    (plus ankle equivalents W20.1, W24.1, W22.1 to capture miscoding)

  • SNOMED CT:
    3381004, 79626009, 208684008, 208685009, 208686005,
    208696001, 208697005, 208698000, 263246003, 429664005

Step 3: Collect and Upload Data

Authorship & Collaboration

FACT-1 follows transparent, collaborative authorship rules:

  • Two authors (senior and junior PI) for the first 10 patients per centre

  • One additional author for every subsequent block of 10 patients

  • Example: 43 patients = up to six authors from that Trust

 

NIHR Recognition

As an NIHR Portfolio Database Study, collaborators are also eligible to participate in the NIHR Associate Principal Investigator (API) Scheme, offering formal recognition for research involvement.

Contact

For study-specific questions, please contact the FACT-1 steering committee: fact1.study@gmail.com

Please do not send any patient data or identifiable information to this email address. All data uploads must be completed via the secure study platform.

FACT-1 marks the beginning of a wider collaborative effort to strengthen evidence in foot and ankle trauma.

We’re excited to work with colleagues across the UK and look forward to sharing the results at BOFAS 2026.

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