Journal of the Pediatric Orthopaedic Society of North America最新文献

{"title":"Patients and Parents Prefer Scrubs: An Analysis of Pediatric Orthopaedic Physician Attire in the Post-COVID Pandemic Era","authors":"Nicolas Pascual-Leone, Preston W. Gross, Danielle E. Chipman, Shevaun M. Doyle, Peter D. Fabricant","doi":"10.55275/jposna-2023-552","DOIUrl":"https://doi.org/10.55275/jposna-2023-552","url":null,"abstract":"Background : Previous studies have demonstrated that dress style can influence a patient’s impression of a physician’s compassion, trust, and competency. The purpose of this study was to understand the preferences pediatric patients and their caregivers have towards physician attire in the orthopaedic outpatient setting. The authors hypothesized that patients and parents/guardians would have no preference regarding the use of white coats and would prefer scrubs over other attire options. Methods : Between January and May 2022, patients aged 10 to 21 and their parents/guardians presenting to an outpatient orthopaedic office visit were approached to complete an anonymous, voluntary survey. The survey consisted of preference questions related to white coats, male physicians’ attire, and female physicians’ attire. Categorical variables were analyzed using Pearson Chi-Square with p≤0.05 used as threshold for statistical significance. A kappa analysis was performed to compare agreement between pediatric patients’ and their respective parents/guardians’ responses. Results : A total of 200 participants’ surveys were included in analysis: 100 patients and 100 parents/guardians. Patients had an average age of 14.1±2.4 years and were 47.0% female, while parents/guardians had an average age of 47.3±6","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124611634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Column Osteotomies in Adolescent Idiopathic Scoliosis","authors":"Craig R. Louer Jr., K. Illingworth, Tyler D. Metcalf, L. Floccari","doi":"10.55275/jposna-2023-638","DOIUrl":"https://doi.org/10.55275/jposna-2023-638","url":null,"abstract":"The posterior column osteotomy (PCO) is an adjunct technique for obtaining deformity correction during posterior spine fusion procedures. Full disarticulation of the posterior spinal column, including bony elements (namely the lamina and facet joints) and ligamentous complex is described as a PCO. This technique was originally described to allow for shortening of the posterior column during correction of excessive thoracic kyphosis; however, its indications have since been expanded to other spine deformities such as adolescent idiopathic scoliosis (AIS). Its expanded role in deformity surgery has been met with controversy: proponents tout increased flexibility and better spinal correction in three planes, while detractors cite lack of ostensible clinical benefit and potential for more complications. Differences in surgical technique are also prevalent. In this manuscript, we review the surgical technique of PCOs, including the traditional PCO as well as a modified posterior column release (PCR). Additionally, the controversy over when this technique should be utilized is further explored through summation of current literature on PCO outcomes.","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116205162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve Transfers in the Lower Extremity","authors":"Phillip T. Grisdela Jr., Peter J. Ostergaard, Colyn J. Watkins, A. Bauer","doi":"10.55275/jposna-2023-605","DOIUrl":"https://doi.org/10.55275/jposna-2023-605","url":null,"abstract":"The utilization of nerve transfer procedures in the upper extremity following brachial plexus injury, trauma, spinal cord injury, tumors, infection, or other etiologies are well established. Nerve injuries in the lower extremity pose several additional challenges, including longer distance to target motor end plates, delayed presentation, and concomitant limb trauma. Nerve transfers in the lower extremity have the potential to provide functional (sensory or motor) recovery distally after direct surgical coaptation of a functional donor nerve to a non-functional recipient nerve. The ability to perform pure motor or sensory fascicular transfers allows for focused recovery while limiting donor morbidity. Indications for nerve transfers in the lower extremity are evolving, but transfers have been utilized for non-recovering peroneal, obturator, femoral, or tibial nerve palsies, to provide protective sensation to the plantar aspect of the foot as well as for painful neuropathies/neuromas. There is a paucity of orthopaedic literature on this topic and our review aims to highlight the current state of lower extremity nerve transfers as they relate to the practicing orthopaedist, including future directions in the field.","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133031231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Sides to Every Conversation: Communication Strategies and Appropriate Interpreter Utilization in Pediatric Orthopaedics","authors":"L. Bellaire, Elizabeth T. Lee-Ray, M. Payares-Lizano, S. Bidar-Sielaff","doi":"10.55275/jposna-2023-648","DOIUrl":"https://doi.org/10.55275/jposna-2023-648","url":null,"abstract":"","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134495819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Equity for Children with Disabilities","authors":"A. Houtrow, C. Sabatini, J. Jarvis","doi":"10.55275/jposna-2023-634","DOIUrl":"https://doi.org/10.55275/jposna-2023-634","url":null,"abstract":"Like all children, children with disabilities deserve the fair and just opportunity to be as healthy as possible. There are many barriers to optimal health for children with disabilities. Eliminating health disparities requires removing or minimizing the obstacles that keep children from being healthy. Because pediatric orthopaedic surgeons are often engaged in the clinical management of children with temporary or permanent disabilities, they are uniquely suited to advocate for inclusive orthopaedic care for all children regardless of their circumstances. Pediatric orthopaedic surgeons can promote health equity for children with disabilities by recognizing how ableist beliefs and actions negatively impact the clinical care of children with disabilities and can take action by addressing biases in their clinical practices and beyond.","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124586649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Step-by-Step Guide to Understanding and Conducting Quality Improvement Initiatives in Orthopaedic Surgery","authors":"Maike van Niekerk, K. Shea, J. Samora, Kerwyn C. Jones, Brian K. Brighton, S. Pinney, Kali R. Tileston","doi":"10.55275/jposna-2023-631","DOIUrl":"https://doi.org/10.55275/jposna-2023-631","url":null,"abstract":"Numerous frameworks have been developed as methods to address complex quality improvement (QI) problems. We aim to provide orthopaedic surgeons with a foundational understanding of QI in order to facilitate their engagement in QI initiatives. We begin by providing a broad overview of QI terms and frameworks and then present a step-by-step guide for conducting QI initiatives using a popular, intuitive, and practical method: Lean (A3). We accompany our descriptions with links to publicly accessible short QI videos developed by the Stanford Medicine Center for Improvement. Additionally, we list key educational resources offered by the American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) as well as provide information on a recently published textbook devoted to QI and patient safety in orthopaedic surgery","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115935171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Past President's Message","authors":".H-SK-it.'--...-MM -or, G. Hall","doi":"10.55275/jposna-2023-624","DOIUrl":"https://doi.org/10.55275/jposna-2023-624","url":null,"abstract":"The 2022 POSNA Annual Meeting Pre-Course was the last single topic pre-course for POSNA. Going forward, the Annual Meeting will commence in the morning with a full academic agenda, including scientific talks and symposia. For the last pre-course, I wanted to choose a topic that was of vital importance to POSNA and required a deeper dive: Diversity, Equity, and Inclusion. I commend our pre-course chair, Dr. Julie Samora, on developing and executing an extraordinary program. Diversity issues are a hot topic; however, they remain difficult to discuss openly and are challenging to develop actionable strategies.\u0000The title of the pre-course was “Improving Patient Care through Diversity, Equity, and Inclusion.” This was intentional. The mission of POSNA is to “Advance Pediatric Orthopaedics by Promoting Education, Research, and Quality Care.” Diverse organizations make better decisions and outperform nondiverse organizations. Culturally appropriate healthcare that appreciates diversity is ultimately better for patients and results in better patient outcomes. Thus, diversity is not just politically correct, it is essential for our profession and our patients. \u0000As a subspecialty, Pediatric Orthopaedics leads the overall profession of Orthopaedic Surgery in terms of diversity. Approximately 25% of POSNA active members are female, and approximately 40% of candidate members are female. However, this is like having the fastest time in the slowest heat. Orthopaedic Surgery has the least diversity in terms of sex and race of all medical professions. Approximately 7% of AAOS members are female. Women account for 14.5% of orthopaedic residents; however, only 3.5% of orthopaedic residents are Hispanic/Latino and only 5.4% are African-American. This is unacceptable. \u0000What can POSNA do? POSNA must continue to lead in terms of greater diversity, equity, and inclusion within Pediatric Orthopaedics and orthopaedics at large. POSNA established a diversity task force that has been formalized into the Justice, Equity, Diversity, and Inclusion (JEDI) standing committee within the President’s Council. The Board of Directors has established a restricted fund to support DEI initiatives, including research grants specific to diverse investigators within pediatric orthopaedics. POSNA continues to work with organizations such as Nth Dimensions, the Ruth Jackson Society, the J. Robert Gladden Society, and AAOS to grow the pipeline of females and underrepresented minorities within Orthopaedic Surgery. At the 2022 Annual Meeting and IPOS®, POSNA supported Pride Ortho, which hosted an amazing reception for LGBTQ+ members and their allies. \u0000But POSNA must do more. As the first Asian-American President of POSNA, I appreciate what it is like to be the other; however, we cannot fully understand each other’s unique experiences. The POSNA Board of Directors includes 30% women and 30% non-white members. We need more women and underrepresented minorities in positions of leadership in the so","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133173955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Implicit Bias and Current Culture in Orthopaedic Surgery","authors":"Selina C. Poon","doi":"10.55275/jposna-2023-606","DOIUrl":"https://doi.org/10.55275/jposna-2023-606","url":null,"abstract":"Orthopaedic surgery continues to be the least diverse subspecialty in medicine. The current culture and implicit bias contribute to the difficulty in recruiting qualified individuals who do not fit the stereotypical orthopaedic surgeon mold. Bullying, discrimination, and sexual harassment persist in our specialty, creating an unwelcoming environment for diverse students considering orthopaedics. Active effort must be employed to create a more welcoming culture.\u0000 ","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133045910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Diverse and Inclusive Teams in Orthopaedic Surgery: Creating a Culture that Supports Diversity of Background and Thought","authors":"Leta Ashebo, J. Flynn","doi":"10.55275/jposna-2023-573","DOIUrl":"https://doi.org/10.55275/jposna-2023-573","url":null,"abstract":"Orthopaedic surgery has remained one of the least diverse medical specialties for decades. This reality drives our division’s targeted efforts to build more inclusive clinical and research teams. These efforts include promoting a pipeline of diverse talent through early, deliberate recruitment and prioritizing sponsorship as an advocacy tool for underrepresented backgrounds in medicine. Through this process, we have made sure to uphold curiosity and accountability. Here we seek to describe how we have used these considerations and efforts to work towards making the orthopaedics division we inherited more representative of our patients and communities.  ","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129844344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Note","authors":"Julie Balch Samora","doi":"10.55275/jposna-2023-635","DOIUrl":"https://doi.org/10.55275/jposna-2023-635","url":null,"abstract":"The current composition of the pediatric orthopaedic workforce does not reflect the U.S. population. However, a diverse workforce can improve productivity, innovation, communication, patient satisfaction, equitable care, and can increase care for the underserved, reduce health disparities, and ultimately enhance overall population health. In this supplement, issues surrounding diversity, equity, and inclusion will be reviewed. Diversity can relate to race/ethnicity, gender, age, socioeconomic status, sexual orientation, disability, work experience, and political beliefs. Equity refers to fairness and justice focusing on outcomes, keeping in mind that everyone faces different challenges and has unique needs. Inclusion involves authentic and empowered participation, with a true sense of belonging and full access to opportunities.\u0000The objectives for this supplement include expanding readers’ existing knowledge to be able to: 1) enhance the learning and work environment and improve patient outcomes by cultivating diversity, equity, and inclusion; 2) assess and appreciate individual implicit biases and develop tools to minimize unconscious biases when working with others, training young surgeons, and caring for patients; and 3) develop skills to address unique needs and considerations of individuals in non-majority populations.\u0000I would like to express my gratitude to Mininder Kocher, MD, who enthusiastically supported this Pre-Course, and to Ken Noonan, MD, who graciously agreed to publish these discussions in JPOSNA®. I would like to thank each of the authors for summarizing the literature in their distinct areas and for sharing their words of wisdom. And of course, none of this would be possible without Lisa DuShane’s constant beating of the drum, moving us toward the finish line.\u0000I hope you enjoy this rich compilation of data, anecdotes, and suggestions to make our pediatric orthopaedic environment an open, inclusive, and supportive place to work, learn, and heal.","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115824800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}