Physician wellness in orthopaedic surgery : a multinational survey study.

Aims: Physician burnout and its consequences have been recognized as increasingly prevalent and important issues for both organizations and individuals involved in healthcare delivery. The purpose of this study was to describe and compare the patterns of self-reported wellness in orthopaedic surgeons and trainees from multiple nations with varying health systems.

Methods: A cross-sectional survey of 774 orthopaedic surgeons and trainees in five countries (Australia, Canada, New Zealand, UK, and USA) was conducted in 2019.

Prediction of mechanical behavior of cartilaginous infant hips in pavlik harness: A subject-specific simulation study on normal and dysplastic hips.

In dysplastic infant hips undergoing abduction harness treatment, cartilage contact pressure is believed to have a role in therapeutic cartilage remodeling and also in the complication of femoral head avascular necrosis. To improve our understanding of the role of contact pressure in the remodeling and the complication, we modeled cartilage contact pressure in cartilaginous infant hips undergoing Pavlik harness treatment. In subject-specific finite element modeling, we simulated contact pressure of normal and dysplastic hips in Pavlik harness at 90° flexion and gravity-induced abduction angles of 40°, 60° and 80°.

Reliability of 2D and 3D ultrasound for infant hip dysplasia in the hands of novice users.

Purpose: Developmental dysplasia of the hip (DDH) diagnosis by two-dimensional ultrasound (2DUS) can have poor inter-rater reliability. 3D ultrasound (3DUS) may be more reliably performed, particularly by novice users. We compared intra- and inter-rater reliability between expert and novice operators performing 2DUS and 3DUS for DDH.

Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study.

Purpose To validate accuracy of diagnosis of developmental dysplasia of the hip (DDH) from geometric properties of acetabular shape extracted from three-dimensional (3D) ultrasonography (US). Materials and Methods In this retrospective multi-institutional study, 3D US was added to conventional two-dimensional (2D) US of 1728 infants (mean age, 67 days; age range, 3-238 days) evaluated for DDH from January 2013 to December 2016. Clinical diagnosis after more than 6 months follow-up was normal (n = 1347), borderline (Graf IIa, later normalizing spontaneously; n = 140) or dysplastic (Graf IIb or higher, n = 241).

Primary Wound Closure After Open Fracture: A Prospective Cohort Study Examining Nonunion and Deep Infection.

Objectives: Determine the proportion of subjects developing deep infection or nonunion after primary wound closure of open fractures (humerus, radius/ulna, femur, and tibia/fibula). Secondarily, a matched-series analysis compared outcomes with subjects who underwent delayed wound closure.

Design: Prospective cohort between 2009 and 2013 of subjects undergoing primary closure.

Factors Associated With Development of Nonunion or Delayed Healing After an Open Long Bone Fracture: A Prospective Cohort Study of 736 Subjects.

Objectives: To determine factors associated with developing nonunion or delayed healing after open fracture.

Design: Prospective cohort between 2001 and 2009.

Setting: Three level 1 Canadian trauma centers.

Does Topical Anesthetic Reduce Pain During Intraosseous Pin Removal in Children? A Randomized Controlled Trial.

Background: The purpose of this study was to determine the effectiveness of topical liposomal lidocaine in reducing the pain perceived by children undergoing percutaneous intraosseous pin (PP) removal in the outpatient orthopaedic clinic.

Methods: A triple-blinded, randomized, placebo-controlled clinical trial comparing topical liposomal lidocaine to a placebo was conducted at the Stollery Children's Hospital between September 2008 and February 2011. Subjects undergoing the removal of PP in the orthopaedic outpatient clinic between ages 3 and 16 years were recruited.

The Quality of Randomized Controlled Trials in Pediatric Orthopaedics: Are We Improving?

Purpose: The quality of randomized controlled trials (RCTs) in orthopaedics is a topic of considerable importance, as RCTs play a major role in guiding clinical practice. The quality of RCTs published between 1995 and 2005 has previously been documented. The purpose of the current study was to assess and describe the quality of pediatric orthopaedic RCTs published from 2005 to 2012, by identifying study characteristics associated with higher quality and outlining areas for improvement.

Time to initial operative treatment following open fracture does not impact development of deep infection: a prospective cohort study of 736 subjects.

Objectives: To evaluate the association between time to surgery, antibiotic administration, Gustilo grade, fracture location, and development of deep infection in open fractures.

Design: Prospective cohort between 2001 and 2009.

Setting: Three Level 1 Canadian trauma centers.

A quality assessment of randomized clinical trials in pediatric orthopaedics.

The promotion and practice of evidence-based medicine necessitates a critical evaluation of medical literature, including the criterion standard of randomized clinical trials (RCTs). Recent studies have examined the quality of RCTs in various surgical specialties, but no study has focused on pediatric orthopaedics. The purpose of this study was to assess and describe the quality of RCTs published in the last 10 years in journals with high clinical impact in pediatric orthopaedics.

The effect of time to definitive treatment on the rate of nonunion and infection in open fractures.

Objectives: To determine the association between time to definitive surgical management and the rates of nonunion and infection in open fractures resulting from blunt trauma. To determine the association of other clinical determinants with these same adverse events.

Design: Retrospective review of a consecutive series of open long bone fractures.