Surgical subspecialist distribution and Social Vulnerability Indices in the inland empire.

Background: Access to surgical specialty care differs based on geographic location, insurance status, and subspecialty type. This study uses the Inland Empire as a model to determine the relationship between Social Vulnerability Indices (SVIs), surgeon sex, and surgical subspecialty distribution.

Methods: 823 census tracts from the Centers for Disease Control's (CDC) SVI 2018 database were compared against 992 surgeons within 30 distinct subspecialties.

Does Marijuana Smoking Increase the Odds of Surgical Site Infection After Orthopaedic Surgery? A Retrospective Cohort Study.

Objectives: Does marijuana smoking increase the risk of surgical site infection (SSI) after open reduction and internal fixation of fractures?

Design: Retrospective.

Setting: Single academic level 1 trauma center in Southern California.

Patient Selection Criteria: Adult patients who underwent open treatment for closed fractures between January 2009 and December 2021, had hardware placed, and had at least 6 months of postoperative follow-up.

Effect of CURES Legislation on Narcotic Prescriptions After Soft-tissue Hand Surgery.

California's Controlled Substance Utilization Review and Evaluation System (CURES) was mandated in 2018 to monitor and limit opiate prescriptions. This study evaluated the effects of this legislation on postoperative opioid prescriptions of patients undergoing soft tissue hand surgery. Patients receiving carpal tunnel release, trigger finger release, and ganglion excisions 18 months prior to and 18 months after CURES were selected.

A Look Into How the "Blue Zone" Lifestyle May Affect Patients' Lives Before and After Hip Fracture: A Propensity-Matched Cohort Study.

Introduction: Hip fractures are life-changing injuries with associated one-year mortality up to 30%. Five locations in the world have been termed "blue zones," where the longevity of the population is markedly higher than that of surrounding areas and there are 10 times more centenarians. The United States has one blue zone (Loma Linda, California), which is believed to be because of the lifestyle of the Seventh-day Adventist population living there.

Fluoroscopy and Radiographs for Detecting Retained Surgical Needles in the Hand.

When a surgical needle is lost, the protocol is to explore the surgical field and to obtain a plain radiograph if the needle cannot be located. The size of the needle that can be detected with imaging is debated. Plain-film radiographs, C-arm, and mini C-arm fluoroscopy imaging was obtained of a cadaveric hand with retained needle of varying lengths (suture sizes 4-0 - 10-0).

Analyzing the association between social vulnerability indexes and surgically underserved areas in the Inland Empire.

Background: The United States lacks equitable surgical access, prompting us to investigate whether there is an inverse relationship between Social Vulnerability Indices and the number of surgeons in a census tract, using the Inland Empire as a model.

Methods: The Centers for Disease Control's (CDC) SVI 2018 database, composed of 823 census tracts, was compared against demographics of 1008 surgeons, from the American Medical Association's (AMA) 2018 Physician Masterfile. Analysis was performed via Spearman's bivariate and multiple regression.

Recent Trends in the Effect of Race and Gender on the Orthopedics Match.

Introduction Orthopedics has a reputation for being competitive but not diverse. Leaders of the orthopedics community have been making efforts to increase the participation of women and minorities in the field by raising awareness and strengthening pipeline programs. We aim to explore the trends in the risk of not matching by comparing the proportions of women and underrepresented populations in the applicant pools versus proportions in residency programs.

Do All-terrain or Recreational Off-highway Vehicle Crashes Have a Higher Odds of Amputation?

Background: Riding off-road vehicles is associated with the risk of injury to the extremities. There are two main types of four-wheel recreational off-road vehicles: quads or all-terrain vehicles (ATVs), which are essentially four-wheel off-road motorcycles, and recreational off-highway vehicles (ROVs), also colloquially referred to as utility terrain vehicles, which have side-by-side seating, higher maximum speeds, and a roll cage. There are multiple orthopaedic society position statements on ATVs, but none on ROVs.

Traumatic Humeral Diaphysis Extrusion and Replantation With Periosteal Involvement.

Open fractures that produce an extruded long bone diaphysis, such as this case, are an exceedingly rare incident, with even fewer cases documented, leading to difficult medical decision-making for the operative management of such situations. Options for operative management include replantation following sterilization of the extruded fragment, bone transport, a vascularized fibular graft, and even allograft reconstruction. Each option is associated with high and variable levels of risk.

Report on the Evidence-Based Practice Committee's Survey on Dupuytren Disease.

Purpose: The Evidence-Based Practice Committee of the American Society for Surgery of the Hand (ASSH) set out to assess the membership's practice patterns (PPs) and knowledge of evidence-based principles for Dupuytren disease (DD).

Methods: A 21-item multiple-choice survey was distributed to all ASSH members via email in June 2020. Questions were divided into 2 types: evidence-based practice (EBP) and PPs.

Calcium released by osteoclastic resorption stimulates autocrine/paracrine activities in local osteogenic cells to promote coupled bone formation.

A major cause of osteoporosis is impaired coupled bone formation. Mechanistically, both osteoclast-derived and bone-derived growth factors have been previously implicated. Here, we hypothesize that the release of bone calcium during osteoclastic bone resorption is essential for coupled bone formation.

The Effect of Upper Extremity Tourniquet Time on Postoperative Pain and Opiate Consumption.

Background: There is widespread use of pneumatic tourniquet for both upper and lower extremity orthopedic surgeries. Tourniquet use improves visualization, decreases blood loss, and as a result, decreases operative time. Exceeding a certain amount of tourniquet time can cause lasting neuromuscular damage.

Effect of Remote Proctoring of the Orthopaedic In-training Examination on Scores.

Introduction: The pandemic has created an opportunity to explore different testing settings. However, transitioning to remote testing raises concerns about cheating. The possibility of cheating raises concern about the integrity of test psychometrics.

Is Grit Associated with Burnout and Well-being in Orthopaedic Resident and Faculty Physicians? A Multi-institution Longitudinal Study Across Training Levels.

Background: Grit has been defined as "perseverance and passion for long-term goals" and is characterized by maintaining focus and motivation toward a challenging ambition despite setbacks. There are limited data on the impact of grit on burnout and psychologic well-being in orthopaedic surgery, as well as on which factors may be associated with these variables.

Questions/purposes: (1) Is grit inversely correlated with burnout in orthopaedic resident and faculty physicians? (2) Is grit positively correlated with psychologic well-being in orthopaedic resident and faculty physicians? (3) Which demographic characteristics are associated with grit in orthopaedic resident and faculty physicians? (4) Which demographic characteristics are associated with burnout and psychologic well-being in orthopaedic resident and faculty physicians?

Methods: This study was an institutional review board-approved interim analysis from the first year of a 5-year longitudinal study of grit, burnout, and psychologic well-being in order to assess baseline relationships between these variables before analyzing how they may change over time.

Do Orthopaedic Residency Programs Have the Least Time Between Invitation and Interview?

Background: The cost and stress of applying to residency programs are increasing. Planning for interviews with limited lead time can cause additional burden to residency applicants.

Objective: We sought to determine if the specialty of orthopaedics was affording the same lead time between interview invitation and interview dates as its surgical and medical counterparts.

Visual Estimation of Length by Orthopaedic Surgeons: How Accurate Are Lengths Estimated in Digital Images Compared to In-Person Estimations?

Orthopaedic surgeons are frequently required to make estimations, often without the use of measuring tools, including the lengths of wounds, incisions, bone fragments, and soft tissue defects. To evaluate the accuracy of these estimations, simulated wounds of randomized lengths were drawn on a healthy volunteer. Resident and attending physicians estimated the length of each wound via digital photograph and subsequently in person.