Interprogram Differences in Core General, Core Plastic, and Plastic Surgery-Adjacent Training.

Background: Plastic surgery training continues to evolve with integrated residents spending more time in plastic versus general surgery. Herein, we provide an updated description of interprogram differences in core general, core plastic, and plastic surgery-adjacent training curricula.

Methods: We obtained rotation schedules from US plastic surgery residency websites or program coordinators for AY2021-2022.

Small Joint Denervation of the Hand and Thumb Base: History, Anatomy, Technique, and Outcomes.

Painful arthritis of the small joints of the hand is a common condition affecting older adults, with distal interphalangeal joint and thumb carpometacarpal joint being the two most common locations. Younger adults may also develop painful arthritis after trauma and with inflammatory arthropathy. Traditional surgical approaches address the structure of the joints with either arthrodesis or arthroplasty with or without an implant.

Selective Thumb Carpometacarpal Joint Denervation Versus Trapeziectomy and Ligament Reconstruction With Tendon Interposition for Painful Arthritis: A Prospective Study With 2 Years of Follow-Up.

Purpose: Thumb carpometacarpal (CMC) joint denervation is a relatively novel method for the management of osteoarthritis-associated pain by selective transection of articular nerve branches of the CMC joint. This study compared functional/patient-reported outcomes after CMC denervation with those after trapeziectomy and ligament reconstruction with tendon interposition (T + LRTI) over a 2-year follow-up period. We hypothesized that the outcomes of denervation and T + LRTI would be similar over the course of the study and at the final 2-year follow-up.

Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Follow-Up of Long-Term Clinical Outcomes.

Purpose: Thumb carpometacarpal (CMC) joint osteoarthritis is a common problem affecting up to 85% of patients over the age of 70. The most common presenting symptom for patients with CMC arthritis is pain with joint loading. Loss of function due to subluxation or joint destruction is comparatively rare.

Congenital Lower Extremity Anomaly Pathology and Reconstruction: A Review of the Literature.

With the advent of the subspecialty of orthoplastic surgery, there has been a greater involvement of plastic surgeons in limb reconstruction, congenital anomalies, and salvage procedures. Understanding embryology helps plastic surgeons better understand how to reconstruct lower extremity congenital defects and how development of the lower limb affects what can be done to reconstruct the adult lower limb. There is significant discussion in the literature regarding embryology and development of craniofacial structures and the upper extremity; however, the development of the lower limb remains largely unexplored.

Integrated Plastic Surgery Residency Applicant Perceptions of Virtual Interviews.

Purpose: The 2020-2021 interview cycle for integrated plastic surgery applicants was the first to be held virtually because of the COVID-19 pandemic. Here, we detail the largest study on integrated plastic surgery applicant perceptions after the virtual interview cycle.

Methods: A 35-question institutional review board-approved survey was distributed to medical students who had applied to the Johns Hopkins/University of Maryland or University of California San Diego integrated residency programs during the 2020-2021 interview cycle.

Differences in Applicant Perceptions of Virtual Interviews Between Integrated Plastic Surgery and Subspecialty Fellowship Applicants.

Objective: We aim to survey and compare integrated plastic surgery and plastic surgery subspecialty fellowship applicants on their experiences with virtual interviews and to determine if there are differences between them.

Design: An IRB-approved survey study was conducted using the Qualtrics platform.

Setting: The study was conducted at the Johns Hopkins University and the R Adams Cowley Shock Trauma Center in Baltimore Maryland.

Predicting Academic Performance during Plastic Surgery Residency: Can Step 2 Scores Reliably Replace Step 1?

Objective: Step 1 will transition to a pass/fail system in 2022. This study aimed to characterize the effects of this change on integrated plastic surgery program directors' selection criteria and assess whether Step 2 Clinical Knowledge (CK) can replace Step 1 as an application selection metric.

Design: Online survey that was administered to a collaborative group of ten plastic surgery program directors collecting USMLE Step 1, Step 2 CK, In-Service, and written board scores for 3 years of graduated integrated residents.

Chronic Nerve Pain after Burn Injury: An Anatomical Approach and the Development and Validation of a Model to Predict a Patient's Risk.

Background: A model that predicts a patient's risk of developing chronic, burn-related nerve pain may guide medical and/or surgical management. This study determined anatomy-specific variables and constructed a mathematical model to predict a patient's risk of developing burn-related nerve pain.

Methods: A retrospective analysis was conducted from 1862 adults admitted to a burn center from 2014 to 2019.

Considerations When Performing Arthrodesis in the Scleroderma Hand.

Background: Hand deformities secondary to scleroderma can limit activities of daily living and be associated with substantial disability. This study aimed to evaluate the outcomes following arthrodesis performed to treat digital contractures secondary to scleroderma.

Methods: We performed a retrospective review of all patients with scleroderma who underwent arthrodesis by a single surgeon from 2015 to 2020.

An Analysis of Gender Bias in Plastic Surgery Resident Assessment.

Background: Previous studies have shown men and women attending physicians rate or provide operating room (OR) autonomy differently to men and women residents, with men attendings providing higher ratings and more OR autonomy to men residents. Particularly with the advent of competency-based training in plastic surgery, differential advancement of trainees influenced by gender bias could have detrimental effects on resident advancement and time to graduation.

Objective: We determined if plastic surgery residents are assessed differently according to gender.

The Association between Away Rotations and Rank Order in the Integrated Plastic Surgery Match.

Background: Given the competition in the integrated plastic surgery Match, away rotations are ubiquitous among plastic surgery applicants to differentiate their applications. This study aimed to characterize how performing an away rotation affects rank order and Match outcomes for integrated plastic surgery programs.

Methods: An online survey was designed and distributed to the top 25 integrated plastic surgery programs in the United States as determined by Doximity.

Surgical Debulking for Symptomatic Management of Calcinosis Cutis of the Hand and Upper Extremity in Systemic Sclerosis.

Purpose: To determine whether elective calcinosis debulking surgery of the hands and/or upper extremities is a safe and effective treatment for painful symptomatic scleroderma. Our hypothesis was that calcinosis debulking surgery would result in improvement in patient-reported pain and range of motion (ROM) with relatively little postoperative surgical pain for scleroderma patients.

Methods: We performed a retrospective review of scleroderma patients who underwent elective calcinosis debulking surgery by a single surgeon between August 2014 and August 2019.

Trends in the research profile of matched independent plastic surgery fellows.

The independent plastic surgery pathway recruits candidates with 5 years of surgical training who are typically more advanced in research than their integrated counterparts. Research productivity helps to discriminate between applicants. However, no studies exist detailing the academic attributes of matched independent plastic surgery candidates.

Academic Productivity Among Plastic Surgery Subspecialty Fellowship Applicants.

Introduction: Plastic surgery subspecialty fellowships are highly competitive. Academic productivity is an objective metric that can be used to compare candidates. This study aims to evaluate intersubspecialty differences in academic profiles of plastic surgery fellows.

Chronic Neuropathic Pain Following Hand Burns: Etiology, Treatment, and Long-Term Outcomes.

Purpose: Chronic neuropathic pain (CNP) after burn injury to the hand/upper extremity is relatively common, but not well described in the literature. This study characterizes patients with CNP after hand/upper extremity burns to help guide risk stratification and treatment strategies. We hypothesize that multiple risk factors contribute to the development of CNP and refractory responses to treatment.

Promoting Gender Equity in the #MeToo Era.

The recent #MeToo movement in social media has brought the important issue of gender-based violence and harassment in the workplace to the forefront of public attention. As in other fields, gender-based discrimination and sexual harassment continue to be a problem in medicine, and gender inequalities are particularly apparent in surgical specialties. Whereas the #MeToo movement has successfully raised awareness and held some perpetrators accountable, there have been unintended backlashes, including reluctance from some male surgeons to mentor female surgeons for fear of false accusations of sexual misconduct at both the trainee and the faculty levels.

Integrated Plastic Surgery Match: Trends in Research Productivity of Successful Candidates.

Background: Plastic surgery continues to be one of the most competitive specialties in the residency match. Research productivity is a key component of the selection process. Nevertheless, potential applicants have a poor understanding of the strength of their research credentials in comparison to other applicants.

Ethics and Professionalism: The Role of Self-Regulation and Peer Review in Maintaining Hand Surgery's Standards.

The practice of hand surgery is bound by the need for each of us to maintain our profession's high standards by fulfilling our peers' and society's expectations regarding ethical and professional behavior. Our profession is self-regulated by local, state, and national organizations, which provide expectations and standards for practice. This manuscript reviews the resources available from such organizations to foster standards of practice.

Comparing Operative Performance between Independent and Integrated Plastic Surgery Residents.

Background: Anecdotally, faculty report that independent residents' operative skills differ from those of their integrated peers. This study compared operative competency between integrated (postgraduate years 4 to 6) and independent plastic surgery residents.

Methods: The authors compared independent (postgraduate years 1 to 3) and integrated (postgraduate years 4 to 6) plastic surgery residents at their institution using operative performance data from the Operative Entrustability Assessment, a validated five-point assessment tool that provides residents with real-time feedback about their operative performance, documenting performance at the point of care.

The Management of Perioperative Immunosuppressant Medications for Rheumatoid Arthritis During Elective Hand Surgery.

Purpose: Rheumatoid arthritis (RA) is a destructive inflammatory disease that commonly involves joints of the hand and wrist. Different recommendations exist for continuing or discontinuing immunosuppressant medications during the perioperative time period. The purpose of our study was to determine whether continuing or discontinuing medications (steroids, nonbiological, and/or biological disease-modifying antirheumatic drugs [DMARDs]) were associated with an increased or decreased risk of postoperative complications.

A Bibliometric Analysis of Research Productivity During Residency for 125 Hand Surgery Fellows.

Purpose: Research output is 1 element of a multifactorial process that fellowships consider when evaluating applicants. Hand fellowships present a unique circumstance in which applicants from various specialties-plastic surgery, orthopedic surgery, or general surgery-may apply. This project aims to assess and compare the research output among current hand surgery fellows who received their residency training in plastic surgery vs.