Volar Distal Radius Buckle Fractures: Is Bracing and Home Management Safe?

Background: A removable brace with home management is widely accepted treatment for distal radius buckle fractures, which most commonly involve the dorsal cortex.

Purpose: The purpose of this study is to determine if a removable brace and home management treatment is safe for volar distal radius buckle fractures.

Materials And Methods: Isolated distal radius buckle fractures in children (3-16 years) diagnosed at an acute care visit (April 1, 2019 to May 31, 2022) were identified.

Reducing Rigid Immobilization for Toddler's Fractures: A Quality Improvement Initiative.

Background: Toddler's fractures are one of the most common orthopedic injuries in young walking-age children. They are defined as nondisplaced spiral-type metaphyseal fractures involving only the tibia without any injury to the fibula and are inherently stable. We aimed to use quality improvement methodology to increase the proportion of patients with toddler's fractures treated without cast immobilization at a large tertiary referral pediatric orthopedic center from a baseline of 45.

How Much Bullying and Discrimination Are Reported by Sexual and Gender Minorities in Orthopaedics?

Background: Discriminatory practices against minority populations are prominent, especially in the workplace. In particular, lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals experience several barriers and stressors more often than individuals who do not identify as LGBTQ+. Mistreatment is common among these individuals in their personal and professional lives.

A Quality Improvement Initiative to Improve After-visit Summary Distribution in Orthopedic Outpatient Clinics.

Unlabelled: Communication and patient education are key to effective healthcare encounters and improved health outcomes. The after-visit summary (AVS) is an integral communication and education tool for patients and families. Without effective communication, gaps in comprehension may result in decreased satisfaction with medical encounters, lack of adherence to recommended treatment plans, missed appointments, and increased malpractice claims.

LGBTQ+ Perspective in Hand Surgery: Surgeon and Patient.

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals and patients face high levels of discrimination both in the workplace and in the clinic setting, with more than 25% of LGBTQ+ people experiencing discrimination in the workplace due to their sexual orientation. Hand Surgery stands to continue to advance by encouraging the brightest students into the field no matter their background. LGBTQ+ patients also have specific needs within the field of Hand Surgery, where we are uniquely positioned to treat them or guide them by being well versed in the needs of the community.

Coaching, Separate from Mentoring, May Provide Skill Acquisition, Improved Well-Being, and Career Advancement in Orthopaedic Surgery: AOA Critical Issues.

Coaching is separate from mentoring, and can include life coaching, skills coaching, and behavior coaching. Life coaching can focus on purpose, work-life balance, well-being, and career path. Skills coaching encourages mastery and promotes autonomy.

To Err is human, but what happens when surgeons Err?

Background: Physicians involved in adverse events may suffer from second victim syndrome and can experience emotional and physical distress long after the complication occurred. We sought determine the prevalence of second victim syndrome among surgeons at our children's hospital and evaluate any differences in how surgeons respond to adverse events based on their age, position, and gender.

Methods: An anonymous 19-question questionnaire distributed via institutional emails linking to an anonymous Research Electronic Data Capture (REDCap) survey.

LGBTQ+ in Orthopaedics: Creating an Open and Inclusive Environment.

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals may encounter added challenges in the healthcare setting. Both providers and patients may face discrimination based on their sexual orientation or gender identity, which may lead to avoidance or delay in seeking care. LGBTQ+ physicians often choose not to disclose their sexual orientation because of concerns about harassment, isolation, and depression.

From Self-efficacy to Imposter Syndrome: The Intrapersonal Traits of Surgeons.

Background: Demographic differences among surgical trainees regarding intrapersonal traits, such as imposter syndrome and assertiveness, have become widely acknowledged. However, many of these characteristics have not been examined in tandem, nor among both trainees and surgeons in practice. This study aimed to address these knowledge gaps.

Brachial Plexus Birth Injuries.

Brachial plexus birth injuries (BPBIs) are typically traction type injuries to the newborn that occur during the delivery process. Although the incidence of these injuries has overall decreased from 1.5 to around 0.

Is methylmethacrylate toxic during pregnancy and breastfeeding?--- a systematic review.

Introduction: Methyl methacrylate (MMA) is commonly used in the fields of dentistry and orthopaedic surgery. However, there remain concerns for the occupational hazards of MMA, particularly during pregnancy and breastfeeding.

Methods: We performed a systematic review of studies on effects that MMA may have in pregnancy in the context of exposure during orthopaedic surgery and dentistry.

Knowledge, Attitudes, and Practices in the Orthopaedic Care of Sexual and Gender Minority Youth: A Survey of Two Pediatric Academic Hospitals.

Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) children and adolescents continue to experience unmet healthcare needs, partly because of clinician biases, discrimination, and inadequate education. Although clinician attitudes and knowledge related to sexual and gender minority health have been well studied in other medical specialties, these have been scarcely studied in orthopaedics.

Questions/purposes: (1) What are pediatric orthopaedic healthcare professionals' attitudes (perceived importance, openness, comfort, and confidence) toward caring for sexual and gender minority youth? (2) What do pediatric orthopaedic healthcare professionals know about caring for this patient population? (3) What factors are associated with clinician attitude and/or knowledge? (4) What existing initiatives to improve orthopaedic care for this population are clinicians aware of at their home institutions?

Methods: All 123 orthopaedic healthcare professionals at two pediatric academic hospitals in the Midwestern and Northeastern United States were sent a 34-question, internet-based, anonymous survey.

Outcomes of Pediatric Scaphoid Nonunions Treated With Distal Radius Cancellous Autograft.

Background: The optimal management of pediatric scaphoid fracture nonunions is controversial. We hypothesize that pediatric patients with scaphoid fracture nonunions will have favorable functional outcomes with the utilization of nonvascularized distal radius cancellous autograft with open reduction and internal fixation (ORIF).

Methods: A review was performed from 2012 to 2017 identifying skeletally immature patients with scaphoid fracture nonunions treated with ORIF and nonvascularized distal radius cancellous autograft, including demographic data, mechanism of injury, length of time from injury to treatment, operative procedure, length of immobilization, time to union, and complications.

Assessing the Prevalence of Microaggressions in Plastic Surgery Training: A National Survey.

Unlabelled: There has been increased awareness of microaggressions occurring during medical training. However, the prevalence and characteristics of microaggressions specifically in plastic surgery residency remain unknown. We aimed to fill this literature gap by conducting a nationwide survey to better understand and characterize microaggressions in plastic surgery training.

Ruth Jackson Orthopaedic Society: Promoting Women in Orthopaedics.

The Ruth Jackson Orthopaedic Society is the oldest organization in the world, supporting women in orthopaedic surgery. The mission is to promote the professional development of women in orthopaedics throughout all stages of their careers. Essential components of the strategic plan include collaboration, communication, and education, with specific domains including diversity and inclusion, professional development, membership, research, and organizational excellence.

Functional outcomes of a modified Duran postoperative rehabilitation protocol after primary repairs of pediatric hand flexor tendon injuries.

The objective of this study was to determine whether pediatric patients undergoing flexor tendon repair who underwent 4 weeks of immobilization followed by a modified Duran controlled passive motion rehabilitation protocol will have favorable outcomes. A study was performed at a tertiary pediatric hospital of patients <18 years who underwent primary flexor tendon repairs in zones 1-4. Outcomes were calculated by total active motion and classified by the original Strickland criteria or Buck-Gramcko criteria.

Long-read whole genome sequencing reveals HOXD13 alterations in synpolydactyly.

Synpolydactyly 1, also called syndactyly type II (SDTY2), is a genetic limb malformation characterized by polydactyly with syndactyly involving the webbing of the third and fourth fingers, and the fourth and fifth toes. It is caused by heterozygous alterations in HOXD13 with incomplete penetrance and phenotypic variability. In our study, a five-generation family with an SPD phenotype was enrolled in our Rare Disease Genomics Protocol.

Influence of seasonal variability on orthopedic surgical outcomes in pediatric patients: a review of surgical site infections.

Surgical site infections (SSIs) are challenging, with highly variable reported rates for children undergoing orthopedic surgery. It has been shown in adults that there is seasonal variability in SSI rates, with peak incidences in the summer months. We reviewed 8766 pediatric orthopedic procedures completed at a quaternary children's hospital over a 43-month period.

Distal Radius Physeal Bar and Ulnar Overgrowth: Indications for Treatment.

Background: Distal radius physeal bar with associated growth arrest can occur because of fractures, ischemia, infection, radiation, tumor, blood dyscrasias, and repetitive stress injuries. The age of the patient as well as the size, shape, and location of the bony bridge determines the deformity and associated pathology that will develop.

Methods: A search of the English literature was performed using PubMed and multiple search terms to identify manuscripts dealing with the evaluation and treatment of distal radius physeal bars and ulnar overgrowth.

A 15-Year Report on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States.

Unlabelled: This study was undertaken to update reports from 2004 to 2005 through 2008 to 2009, and 2009 to 2010 through 2013 to 2014, including 5 additional years of GME Track data. Our hypothesis is there have been no significant changes during the past 5 years in the distribution of Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedics residency programs that train female residents, compared with the previous 10 years.

Methods: Data for ACGME-accredited orthopaedics residency training programs in the United States were analyzed for 5 consecutive academic years (2014-2015 through 2018-2019).

Reducing Surgical Specimen Errors Through Multidisciplinary Quality Improvement.

Background: Each year, our institution performs more than 34,000 surgical cases and obtains close to 10,000 surgical specimens. Within those procedures, we averaged 10 errors for every 1,000 surgical specimens. Any level of preventable harm is unacceptable, as it could lead to risks of treatment delay, improper therapy selection, or missed diagnoses.