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Surprise Billing in Elective Shoulder Surgery and Its Effect on Patient Satisfaction. 肩部选择性手术中的意外计费及其对患者满意度的影响。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2023-09-27 DOI: 10.3928/01477447-20230922-02
Joseph A S McCahon, Jeffrey C Lynch, Tyler Radack, Luke S Austin

Patients often receive multiple bills following surgery, which may come as a surprise to them if they are not appropriately informed or educated prior to surgery. The purpose of this study was to identify whether surprise billing occurs following shoulder rotator cuff repair and its effect on patient satisfaction. The study surveyed adult patients who underwent elective rotator cuff repair from January 2020 to October 2021. Patients were asked if they received unexpected bills after their surgery, as well as about details regarding those bills. Additionally, patients were asked about their medical insurance carrier, knowledge of the billing process prior to surgery, and how they felt the process could be improved. Finally, patients were asked how these bills and the overall billing process affected their surgical satisfaction. Of the 158 responses, 25% of the patients stated they received at least one surprise bill following their rotator cuff surgery, with 57% of these bills being greater than $1000. Patients who received surprise bills reported being significantly less satisfied with their surgery (P<.001) and felt their billing experience affected their surgical satisfaction (64% vs 9%, P<.001). One in 4 patients undergoing elective rotator cuff repair received a surprise bill following surgery. These bills were monetarily substantial and significantly affected surgical satisfaction. Although surgeons may be unable to limit the amount of bills patients receive postoperatively, increased communication and education regarding the perioperative billing process may prove to be beneficial for both patient satisfaction and the physician-patient relationship. [Orthopedics. 2024;47(2):123-127.].

患者在手术后经常会收到多张账单,如果他们在手术前没有得到适当的通知或教育,这可能会让他们感到惊讶。本研究的目的是确定肩袖修复术后是否会出现意外计费及其对患者满意度的影响。该研究调查了2020年1月至2021年10月接受选择性肩袖修复的成年患者。患者被问及手术后是否收到意外账单,以及这些账单的详细信息。此外,患者还被问及他们的医疗保险公司,手术前对账单流程的了解,以及他们认为如何改进流程。最后,患者被问及这些账单和整个账单流程如何影响他们的手术满意度。在158份回复中,25%的患者表示,他们在肩袖手术后至少收到了一份意外账单,其中57%的账单超过1000美元。收到意外账单的患者报告称,他们对手术的满意度明显降低(PPOrthopedic.202x;4x(x):xx-xx.]。
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引用次数: 0
Alteration in Microcirculation With Osteonecrosis of the Femoral Head: A Study of Dynamic Contrast-Enhanced MRI. 股骨头坏死引起的微循环改变:动态增强MRI研究。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2023-09-27 DOI: 10.3928/01477447-20230922-01
ZhaoFeng Yuan, DaWei Huan, WeiQiang Dou, ShaoWei Liu, Chao Lu, Chao Zhang, TianWei Xia, JiRong Shen

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is commonly used in clinical practice to detect tumor blood supply, and it has recently been applied to assess skeletal vasculature. In this study, we retrospectively analyzed DCE-MRI data from 37 patients with osteonecrosis of the femoral head to evaluate alterations in microvascular circulation of the femoral head. Time-intensity curves (TICs) in the region of interest were classified into different lesion stages. In the greater trochanter area, extracellular space volume per unit volume of tissue was significantly higher in Association Research Circulation Osseous (ARCO) stage III than in ARCO stage II (P<.05 and power ≥ 0.8), while other parameters showed no statistical difference (P>.05 and/or power < 0.8). In the necrotic area, contrast enhancement ratio and maximum slope of increase were significantly lower in ARCO stage III than in ARCO stage II (P<.05 and power ≥ 0.8), while other parameters showed no statistical difference (P>.05 and/or power < 0.8). In the repair reaction area, all parameters were significantly higher in ARCO stage III than in ARCO stage II (P<.05 and power ≥ 0.8). TIC classification showed that the greater trochanter area mainly exhibited type C (plateau type), the necrotic area mainly exhibited type B (out-flow type), and the repair reaction area mainly exhibited type A (inflow type). We believe that the exchange capacity of the vessels has a much greater impact on femoral head necrosis than the number of vessels, while the generation of the repair area greatly affects the prognosis of femoral head necrosis. These findings suggest that DCE-MRI can provide a good assessment of osteonecrosis of the femoral head perfusion and can serve as a new reference for clinical treatment decisions. [Orthopedics. 2024;47(2):e73-e78.].

动态增强磁共振成像(DCE-MRI)在临床实践中常用于检测肿瘤血供,最近已应用于评估骨骼血管系统。在本研究中,我们回顾性分析了37例股骨头坏死患者的DCE-MRI数据,以评估股骨头微血管循环的变化。将感兴趣区域的时间-强度曲线(TICs)分为不同的病变阶段。在大转子区域,Association Research Circulation Oseous(ARCO)III期每单位体积组织的细胞外间隙体积显著高于ARCO II期(PP>.05和/或功率<0.8),ARCO III期的对比度增强率和最大增加斜率显著低于ARCO II期(PP>.05和/或功率<0.8)。在修复反应区,ARCO III级的所有参数均显著高于ARCO II级(POrthopedics.202x;4x(x):xx-xx.]。
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引用次数: 0
Early Versus Delayed Weight Bearing and Mobilization After Ankle Fracture Fixation Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. 踝关节骨折固定手术后早期负重和活动与延迟负重和活动的比较:随机对照试验的系统回顾和元分析》。
IF 1.1 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-03-01 Epub Date: 2023-08-09 DOI: 10.3928/01477447-20230804-08
Jaryd Tong, Prabjit Ajrawat, Jaskarndip Chahal, Anser Daud, Daniel B Whelan, Aaron Nauth, Niloofar Dehghan, Graeme Hoit

The purpose of this review was to determine whether there is a benefit to early weight bearing or mobilization in surgically treated ankle fractures. All randomized controlled trials that analyzed early vs delayed weight bearing and/or mobilization after an ankle surgery were included. The primary outcome measure was the pooled Olerud Molander Ankle Score 1 year postoperatively. No significant differences in ankle function were found at 1 year postoperatively between early and delayed weight bearing and mobilization. The 12-week results demonstrated superior early ankle function scores for patients who had early weight bearing. Patients who had early mobilization were at increased risk for postoperative complications. In surgically treated ankle fractures, early weight bearing resulted in improved short-term ankle function scores. [Orthopedics. 2024;47(2):71-78.].

本综述旨在确定踝关节骨折手术治疗后早期负重或活动是否有益。所有分析了踝关节手术后早期负重和/或活动与延迟负重和/或活动的随机对照试验均被纳入其中。主要研究结果为术后1年的奥勒德-莫兰德踝关节评分(Olerud Molander Ankle Score)。术后 1 年,早期与延迟负重和活动踝关节在踝关节功能方面无明显差异。12周的结果显示,早期负重的患者踝关节功能评分更高。早期活动的患者出现术后并发症的风险较高。在接受手术治疗的踝关节骨折患者中,早期负重可改善短期踝关节功能评分。[Orthopedics. 2024;47(2):71-78.].
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引用次数: 0
Atypical Mycobacterial Infections of the Spine: Evaluation and Management. 脊柱非典型分枝杆菌感染:评估与管理》。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI: 10.3928/01477447-20240122-05
Nolan M Wessell, Brandi Krieg, Laura Damioli, Christopher J Kleck

Background: Atypical mycobacterial infections of the spine can be difficult to treat and represent a subset of the vertebral osteomyelitis and diskitis spectrum often requiring early and aggressive surgical intervention. The purpose of this review is to improve the understanding of and approach to disease management from the perspective of the spine surgeon.

Materials and methods: Debridement or excision of the affected levels may be necessary to decrease mycobacterial loads and restore biomechanics. A close relationship with the patient's internal medicine and infectious disease specialists should be maintained to ensure disease eradication or remission. Long-term suppressive antibiotic therapy may be required for infection control.

Results and conclusion: Atypical mycobacterial spine infections are rare, complex, and difficult to eradicate. Our institution proposes a collaborative effort among the spine surgeon, infectious disease specialists, and internal medicine specialists to best approach the work-up, diagnosis, and treatment of these infections. [Orthopedics. 2024;47(2):e61-e66.].

背景:脊柱非典型分枝杆菌感染可能很难治疗,它是椎体骨髓炎和椎间盘炎的一个分支,通常需要早期积极的手术干预。本综述旨在从脊柱外科医生的角度加深对疾病治疗的理解和方法:可能需要对受影响的椎间盘进行清创或切除,以减少霉菌负荷并恢复生物力学。应与患者的内科和传染病专家保持密切联系,以确保疾病得到根除或缓解。为控制感染,可能需要长期抑制性抗生素治疗:结果和结论:脊柱非典型分枝杆菌感染罕见、复杂且难以根除。本院建议脊柱外科医生、传染病专家和内科专家通力合作,以最佳方式对这些感染进行检查、诊断和治疗。[骨科。202x;4x(x):xx-xx]。
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引用次数: 0
Medicaid and Indigent Patients Experience Delayed Fixation of Distal Radius Fractures, Resulting in Worse Consequential Radiographic Outcomes. 医疗补助和贫困患者桡骨远端骨折固定时间延迟,导致放射学后果恶化。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2023-06-21 DOI: 10.3928/01477447-20230616-04
Cristina T Graphia, Samuel H Klatman, Rachel E Hein, Claudia Leonardi, Robert D Zura, Marc J Richard

Distal radius fractures are the most common upper extremity injury. Patients referred to safety-net tertiary facilities following a fracture experience significant delays in treatment because of financial and language barriers as well as poor access to care at outlying community hospitals. This delay in treatment can affect postoperative functional outcomes and complication rates because of failure to restore anatomic alignment. The purpose of this multicenter study was to assess for risk factors associated with delayed fixation of distal radius fractures and evaluate the impact of delayed treatment on radiographic alignment. Patients with a distal radius fracture treated surgically during a 2-year period were identified. Measures included time from injury to surgery, demographic information, fracture classification, and radiographic parameters. The effect of surgery delay on radiographic outcomes was assessed with delayed surgery defined as 11 or more days out from injury. A total of 183 patients met study inclusion criteria. Medicaid and indigent patients were more likely to experience a delay in surgical treatment. Specifically, 70% of these patients were treated in a delayed fashion. Delayed treatment of 11 days or more was associated with worse radial height and inclination on postoperative radiographic imaging. Medicaid and indigent patients are more likely to experience delayed fixation in the treatment of distal radius fractures. This delayed surgery negatively affects postoperative radiographic outcomes. These findings suggest a need to improve access to care for Medicaid and indigent patients and to proceed with operative intervention within 10 days for distal radius fractures. [Orthopedics. 2024;47(2):e93-e97.].

桡骨远端骨折是最常见的上肢损伤。由于经济和语言障碍,以及外围社区医院的医疗条件较差,骨折后转诊至安全网三级医疗机构的患者在接受治疗时会遇到严重的延误。这种治疗延误可能会影响术后功能结果和并发症发生率,因为无法恢复解剖对位。这项多中心研究旨在评估与桡骨远端骨折延迟固定相关的风险因素,并评估延迟治疗对放射学对位的影响。研究对象为两年内接受过手术治疗的桡骨远端骨折患者。测量指标包括从受伤到手术的时间、人口统计学信息、骨折分类和放射学参数。评估了手术延迟对放射学结果的影响,延迟手术的定义是受伤后 11 天或 11 天以上。共有 183 名患者符合研究纳入标准。医疗补助和贫困患者更有可能经历手术治疗延迟。具体来说,这些患者中有 70% 接受了延迟治疗。延迟治疗 11 天或更长时间与术后放射成像中桡骨高度和倾斜度的恶化有关。医疗补助和贫困患者在治疗桡骨远端骨折时更有可能经历延迟固定。这种延迟手术会对术后放射成像结果产生负面影响。这些研究结果表明,有必要改善医疗补助和贫困患者的就医条件,并在 10 天内对桡骨远端骨折进行手术干预。[Orthopedics. 2024;47(2):e93-e97.].
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引用次数: 0
Large Femoral Heads With Small Acetabular Components: An Examination of 10-Year Polyethylene Wear. 大股骨头配小髋臼组件:10 年聚乙烯磨损检验。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2023-08-09 DOI: 10.3928/01477447-20230804-07
Hope S Thalody, Danielle Y Ponzio, Adam J Santoro, Tyler M Radack, Zachary D Post, Alvin C Ong

Highly cross-linked polyethylene (HXLPE) has improved polyethylene (PE) wear rates while decreasing osteolysis and aseptic loosening. However, concerns exist regarding the risk of mechanical failure with thin HXLPE liners in total hip arthroplasty (THA). Our purpose was to evaluate long-term outcomes and PE wear rates in primary THAs pairing large femoral heads with small acetabular components and thin HXLPE liners. We retrospectively reviewed 29 patients who underwent 33 primary THAs using large femoral heads (32 or 36 mm) with small acetabular components (48 or 50 mm) and thin HXLPE liners (3.9 or 5.9 mm) at minimum 10-year follow-up. PE liner wear was measured using a validated radiographic technique. Mean age was 66 years, 97% of the patients were women, and mean body mass index was 26.3 kg/m2. Thirty hips (90.9%) had ceramic femoral heads, and 13 hips (39%) had 36-mm femoral heads with 3.9-mm HXLPE liners. All cases used a neutral PE design. Mean linear wear rate and volumetric wear rate were 0.04 mm/year and 39.6 mm3/year, respectively, at mean 10.9-year follow-up. There were no instances of liner fracture, liner dissociation, or revision. Mean Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) was 92.1. In the largest long-term study of primary THAs using large femoral heads with small acetabular components and thin HXLPE liners, we found low linear and volumetric wear rates and no cases of liner mechanical failures. Thin HXLPE liners are a safe and viable option for THA surgeons. [Orthopedics. 2024;47(2):118-122.].

高交联聚乙烯(HXLPE)提高了聚乙烯(PE)的磨损率,同时减少了骨溶解和无菌性松动。然而,在全髋关节置换术(THA)中使用薄型 HXLPE 内衬的机械故障风险仍令人担忧。我们的目的是评估配用大股骨头、小髋臼组件和薄 HXLPE 内衬的初级全髋关节置换术的长期疗效和 PE 磨损率。我们对 29 名患者进行了回顾性研究,这些患者在至少 10 年的随访中接受了 33 次初级 THAs,使用的是大股骨头(32 或 36 毫米)、小髋臼组件(48 或 50 毫米)和薄 HXLPE 衬里(3.9 或 5.9 毫米)。聚乙烯衬垫的磨损情况采用经过验证的放射学技术进行测量。平均年龄为66岁,97%的患者为女性,平均体重指数为26.3 kg/m2。30个髋关节(90.9%)采用陶瓷股骨头,13个髋关节(39%)采用36毫米股骨头和3.9毫米HXLPE衬垫。所有病例均采用中性聚乙烯设计。在平均10.9年的随访中,线性磨损率和体积磨损率分别为0.04毫米/年和39.6立方毫米/年。没有出现衬垫断裂、衬垫分离或翻修的情况。髋关节残疾和关节置换骨关节炎结果评分(HOOS,JR)的平均值为92.1。在对使用大股骨头、小髋臼组件和薄 HXLPE 内衬的初次全髋关节置换术进行的最大规模的长期研究中,我们发现线性磨损率和体积磨损率都很低,而且没有发生内衬机械故障的病例。对于 THA 外科医生来说,薄 HXLPE 内衬是一种安全可行的选择。[Orthopedics. 2024;47(2):118-122.].
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引用次数: 0
Influence of Anxiety and Depression on Opioid Use After Cervical Spine Fusion: An Analysis of a National Claims Database. 焦虑和抑郁对颈椎融合术后阿片类药物使用的影响:对国家索赔数据库的分析。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2023-09-27 DOI: 10.3928/01477447-20230922-03
Heeren Makanji, Matthew J Solomito, Regina Kostyun, Sean Esmende

Patients with spine pathology demonstrate an above average rate of active psychiatric disorders, which can influence their recovery. This study was designed to understand how mental health diagnoses (ie, anxiety and depression) influence a patient's postoperative need for opioids after a single level cervical spine fusion. The PearlDiver database was used to identify patients. Patients were placed into one of four groups: those with a diagnosis of depression, those with a diagnosis of anxiety, those with a diagnosis of both anxiety and depression, and a control group. Chi-square tests were used to assess differences in the number of patients filling initial and additional opioid prescriptions for up to 90 days after their fusion. A total of 168,967 patients who underwent an elective cervical spine fusion in the United States between 2010 and 2021 were included in this study. The control group filled significantly more opioid prescriptions within the first 90 days after their cervical fusion (P<.001). There was no difference among the study groups regarding the need to fill additional opioid prescriptions. Patients with a diagnosis of depression and/or anxiety may present as complex patients; however, results suggest they do not need additional opioids for pain control after a single level cervical spine fusion. [Orthopedics. 2024;47(2):89-94.].

脊柱病变患者的活动性精神障碍发生率高于平均水平,这可能会影响他们的康复。这项研究旨在了解心理健康诊断(即焦虑和抑郁)如何影响患者在单级颈椎融合术后对阿片类药物的术后需求。PearlDiver数据库用于识别患者。患者被分为四组之一:诊断为抑郁症的患者、诊断为焦虑症的患者、同时诊断为焦虑和抑郁的患者以及对照组。卡方检验用于评估患者在融合后90天内首次和额外开具阿片类药物处方的人数差异。本研究纳入了2010年至2021年间在美国接受选择性颈椎融合术的168967名患者。对照组在宫颈融合后的前90天内服用了明显更多的阿片类药物处方(POrthopedics.202x;4x(x):xx-xx.]。
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引用次数: 0
Return to Play Rates Following Operative Ankle Fractures Differ Between High- and Low-Performing National Football League Athletes. 全国橄榄球联盟中成绩优秀和成绩较差的运动员在踝关节骨折手术后的重返赛场率存在差异。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-23 DOI: 10.3928/01477447-20230517-05
Jordan B Robbins, Daniel C Jupiter, Vinod K Panchbhavi, William M Weiss, John C Hagedorn, Jie Chen

This study investigated predictive factors for return to play among National Football League athletes after operative treatment of ankle fractures and the impacts of these injuries on career longevity and player performance. Athletes who underwent surgery to repair ankle fractures from the 2013 to 2017 seasons were identified from injury reserve lists and press releases. Demographics and season metrics were collected before and after the injury. Statistical analysis assessed for differences in recorded variables between injured and uninjured players. Thirty-one players met study inclusion criteria. Twenty-two (71%) athletes successfully returned to play. Players who did not return showed no significant differences (P>.05) in position, age, body mass index, number of games or seasons played preinjury, or snaps per game the season prior to injury and had a significantly lower (42.6%, P=.013) preinjury season approximate value (SAV) compared with returning players. Returning athletes showed no significant differences (P>.05) in SAV or snaps per game compared with their preinjury season or with uninjured controls. A high preinjury SAV is associated with successful return to play. No difference in game time or performance metrics was detectable between returning players and uninjured controls, or between preinjury and postinjury seasons. [Orthopedics. 2024;47(1):22-27.].

本研究调查了美国国家橄榄球联盟运动员在接受踝关节骨折手术治疗后重返赛场的预测因素,以及这些损伤对职业生涯寿命和球员表现的影响。研究人员从伤病储备名单和新闻稿中找出了 2013 至 2017 赛季接受踝关节骨折修复手术的运动员。收集了受伤前后的人口统计数据和赛季指标。统计分析评估了受伤和未受伤球员之间记录变量的差异。31 名球员符合研究纳入标准。22名运动员(71%)成功重返赛场。未复出的球员在位置、年龄、体重指数、受伤前的比赛场次或赛季数、受伤前赛季的每场比赛抢断数等方面与复出的球员无明显差异(P>.05),但受伤前的赛季近似值(SAV)明显低于复出的球员(42.6%,P=.013)。与受伤前赛季或未受伤的对照组相比,复出运动员在每场比赛的近似值或出场次数方面没有明显差异(P>.05)。受伤前的高SAV与成功重返赛场有关。复出球员与未受伤的对照组之间,或受伤前与受伤后赛季之间,在比赛时间或表现指标方面均未发现差异。[Orthopedics. 2024;47(1):22-27.].
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引用次数: 0
Quantification of the Safe Zone of the First to Third Sacral Segments for Transiliac-Transsacral Screw Fixation in Normal and Dysmorphic Sacra. 正常和畸形骶骨经髂胫螺钉固定第一至第三骶骨节段安全区的量化。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-06-05 DOI: 10.3928/01477447-20230531-06
Po-Hsiang Chen, Chun-Yu Chen, Kai-Cheng Lin, Chien-Jen Hsu

Transiliac-transsacral screw fixation is widely used to stabilize unstable posterior pelvic ring injuries. Preoperative radiographic assessment of the safe osseous corridor is necessary because the safe space of sacrum is narrower for transiliac-transsacral screw placement than for traditional iliosacral screw placement. However, the radiographic assessment has rarely been studied in the Taiwanese population. We retrospectively analyzed 100 patients with pelvic computed tomography images and divided them into normal and dysmorphic pelvis groups. To determine the safe osseous space, we recorded cross-section area, cross-sectional diameter of the safe zone (CS-szD), and safe zone width on axial view (Ax-szW) in the S1 to S3 segments. The prevalence of dysmorphic pelvis was 48% among all patients. In the S1 segment, no differences were found in the cross-section area and CS-szD been the two groups. However, the Ax-szW was significantly smaller in the dysmorphic pelvis group. In the S2 segment, the cross-section area, CS-szD, and Ax-szW were all significantly larger in the dysmorphic pelvis group. In the S3 segment, the cross-section area and CS-szD of the normal pelvis group were both significantly smaller. No differences were found in the Ax-szW between the two groups. Based on our findings in a Taiwanese population, S1 was the most suitable segment for transiliac-transsacral screw fixation in a normal pelvis, whereas S2, followed by S3, was most suitable in a dysmorphic pelvis. This study offers surgeons information on identifying the optimal sacral segment for transiliac-transsacral screw placement for each pelvic morphology. [Orthopedics. 2024;47(1):e13-e18.].

经髂骨-骶骨螺钉固定术被广泛用于稳定不稳定的骨盆后环损伤。由于经髂横骶螺钉固定的骶骨安全空间比传统的髂骶螺钉固定狭窄,因此术前必须对安全骨走廊进行影像学评估。然而,在台湾人群中很少有人对放射学评估进行研究。我们回顾性分析了 100 名患者的骨盆计算机断层扫描图像,并将其分为正常骨盆组和骨盆畸形组。为了确定安全骨空间,我们记录了 S1 至 S3 段的横截面积、安全区横截面直径(CS-szD)和轴向视图上的安全区宽度(Ax-szW)。在所有患者中,骨盆畸形的发生率为 48%。在 S1 节段,两组患者的横截面积和 CS-szD 均无差异。然而,骨盆畸形组的 Ax-szW 明显较小。在 S2 节段,畸形骨盆组的横截面积、CS-szD 和 Ax-szW 都明显较大。在 S3 段,正常骨盆组的横截面积和 CS-szD 都明显较小。两组的 Ax-szW 没有发现差异。根据我们在台湾人群中的研究结果,在正常骨盆中,S1 是最适合经髂胫螺钉固定的节段,而在畸形骨盆中,S2 最适合,其次是 S3。这项研究为外科医生提供了信息,帮助他们根据不同的骨盆形态确定经髂-经骶螺钉固定的最佳骶骨节段。[Orthopedics. 2024;47(1):e13-e18.].
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引用次数: 0
Analysis of Academic Accomplishments and Demographics for Elected Presidents of National Orthopedic Surgery Organizations in the United States. 美国全国矫形外科组织当选主席的学术成就和人口统计学分析。
IF 1.1 4区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-06-21 DOI: 10.3928/01477447-20230616-02
Jason Silvestre, Sanjum Singh, John D Kelly, Charles L Nelson, Terry L Thompson, James D Kang

This study analyzed the academic accomplishments and demographics of elected presidents of the American Academy of Orthopaedic Surgeons (AAOS), American Orthopaedic Association (AOA), and American Board of Orthopaedic Surgery (ABOS). Curriculum vitae and internet-based resources were reviewed to collect demographics, training characteristics, bibliometrics, and National Institutes of Health (NIH) research funding of contemporary presidents (1990-2020). Eighty presidents were included. Most presidents were men (97%), and 4% of presidents were non-White (3% Black and 1% Hispanic). Few had an additional graduate degree (4% MBA, 3% MS, 1% MPH, 1% PhD). Ten orthopedic surgery residency programs trained 47% of these presidents. Most had fellowship training (59%), and the top three were hand surgery (11%), pediatric orthopedics (11%), and adult reconstruction (10%). Twenty-nine presidents (36%) participated in a traveling fellowship. The mean age at appointment was 58±5 years, which was 27 years since residency graduation. The mean h-index was 36±23, resulting from 150±126 peer-reviewed manuscripts. Orthopedic surgery presidents had more peer-reviewed manuscripts (150±126) than chairs (73±81) and program directors (27±32) (P<.001). AOA presidents had the highest mean h-index (42±21) compared with AAOS (38±27) and ABOS (25±16) presidents (P=.035). Nineteen presidents had NIH funding (24%). More presidents had NIH funding in the AOA (39%) and AAOS (25%) than the ABOS (0%) (P=.007). Orthopedic surgery presidents possess high levels of scholarly output. AOA presidents had the highest h-index values and prevalence of NIH funding. Females and racial minorities remain underrepresented at the highest levels of leadership. [Orthopedics. 2024;47(1):e45-e51.].

本研究分析了美国矫形外科医师学会(AAOS)、美国矫形外科协会(AOA)和美国矫形外科委员会(ABOS)当选主席的学术成就和人口统计学特征。通过查阅简历和互联网资源,收集了当代主席(1990-2020 年)的人口统计学特征、培训特征、文献计量学和美国国立卫生研究院 (NIH) 的研究经费。其中包括 80 位校长。大多数校长为男性(97%),4%的校长为非白人(3%为黑人,1%为西班牙裔)。很少有人拥有额外的研究生学位(4% MBA、3% MS、1% MPH、1% PhD)。十个矫形外科住院医师培训项目培养了其中 47% 的院长。大多数人都接受过研究员培训(59%),排名前三位的分别是手外科(11%)、小儿骨科(11%)和成人重建(10%)。有 29 位院长(36%)参加过巡回奖学金培训。任命时的平均年龄为 58±5 岁,距住院医师毕业已有 27 年。平均 h 指数为(36±23),共发表了 150±126 篇同行评审稿件。骨科外科主任的同行评审手稿数(150±126)多于主任(73±81)和项目主任(27±32)(PP=0.035)。19位院长获得了美国国立卫生研究院的资助(24%)。AOA(39%)和AAOS(25%)中获得NIH资助的院长人数多于ABOS(0%)(P=.007)。矫形外科主席拥有高水平的学术成果。AOA 主席的 h 指数值最高,获得美国国立卫生研究院(NIH)资助的比例也最高。女性和少数种族在最高领导层的代表性仍然不足。[Orthopedics. 2024;47(1):e45-e51.].
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