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

{"title":"The Healthcare Experience of Autistic Patients in Orthopaedic Surgery: A Survey Study of Autistic Patients' Parents, Caregivers, and Orthopaedic Providers.","authors":"Steven D Criss, Maya Fajardo, Sang Won Lee, Mary Dubon, Collin J May","doi":"10.1016/j.jposna.2024.100138","DOIUrl":"10.1016/j.jposna.2024.100138","url":null,"abstract":"<p><strong>Background: </strong>Autistic patients can have different communication and sensory needs, potentially making orthopaedic visits stressful. This study evaluated which factors play the greatest role in autistic patients' comfort and overall experience in orthopaedic settings by surveying the parents, caregivers, and orthopaedic providers of these patients.</p><p><strong>Methods: </strong>We developed two online surveys focused on the experience of autistic patients in orthopaedic settings: one for parents/caregivers and another for orthopaedic surgeons. Parents/caregivers of patients under 26 years of age with a diagnosis of autism spectrum disorder (ASD) and an orthopaedic visit at a single pediatric institution between 2017 and 2022 were eligible. The provider survey was sent via email to members of the Pediatric Orthopaedic Society of North America (POSNA).</p><p><strong>Results: </strong>Parent/caregiver survey: In total, 83 parents/caregivers (mean patient age: 12, 77% male) provided complete responses. The most anxiety-provoking situations included blood draws (49% of patients beyond neutral anxiety level), loud/unfamiliar noises (42%), getting imaging (38%), casting (35%), and cast removal (34%). Parents/caregivers noted that purposeful eye contact, explanations in advance, and use of technology helped improve patient comfort.Provider survey: In total, 61 orthopaedic surgeons responded. The majority of providers reported being aware of an ASD diagnosis in their patients some (48%) or most (40%) of the time. Situations that make autistic patients more anxious/uncomfortable than nonautistic patients included cast removal (80% of respondents), loud/unexpected sounds (77%), imaging (70%), and the physical exam (62%). The most common accommodations in place included child life specialists (53%) and ear plugs/headphones (51%); 18% reported no accommodations. Most providers changed their approach to visits with autistic patients, including discussions with parent/caregiver about patient's preferences (66%) and more time in the room (54%).</p><p><strong>Conclusions: </strong>Orthopaedic practices looking to improve autistic patient experience can prioritize interventions that lower the sensory demands of cast removal, brace fitting, and radiologic imaging. Orthopaedic surgeons are broadly cognizant of the challenges autistic patients face during clinical visits, but improved awareness and accommodations are necessary.</p><p><strong>Key concepts: </strong>(1)Autistic patients can have different communication and sensory needs, potentially making orthopaedic visits stressful and uncomfortable.(2)We surveyed parents/caregivers of autistic patients treated at a single pediatric institution, as well as a national sample of orthopaedic surgeons, regarding the experiences of autistic patients in orthopaedic settings and the factors that make the greatest impact on their experiences.(3)According to autistic patients' parents/caregivers, the most","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100138"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opinion Survey Regarding Practice Environment and Career Satisfaction: The 2021 POSNA Membership Survey.","authors":"Jill Flanagan, Maegen Wallace, Rebecca C Whitesell, Kevin Neal, M Wade Shrader","doi":"10.1016/j.jposna.2024.100140","DOIUrl":"10.1016/j.jposna.2024.100140","url":null,"abstract":"<p><strong>Introduction: </strong>The healthcare environment in North America in the 21st century is in constant flux. The practice setting for many pediatric orthopaedic surgeons continues to evolve. To better understand these shifting healthcare environmental issues, the Practice Management Committee (PMC) of the Pediatric Orthopaedic Society of North America (POSNA) surveyed its membership in 2021 to identify issues related to on-call practices, employment details and the wellbeing of its members.</p><p><strong>Results: </strong>In total, 419 members completed the survey with a response rate of 30%. Most surgeons take trauma call, 80.8%. Despite the inherent challenges of covering call, 92% of respondents feel that call is integral to the field of pediatric orthopaedic surgery and an important aspect of patient care that we as professionals need to continue to provide. Satisfaction with work-life balance correlated with interference with personal life, feeling valued by partners and the institution, autonomy, and feeling supported during complication.</p><p><strong>Conclusion: </strong>The findings in this practice management survey of POSNA members regarding job satisfaction stressed the importance of numerous factors, with compensation not necessarily correlating to job satisfaction. While this survey did not specifically ask about burnout, strategies known to mitigate burnout (such as providing a supportive culture), are also highly correlated to job satisfaction in this survey. Therefore, it is important for individual institutions, institutional leaders, and POSNA leadership to adopt wellness strategies not only for the health of the pediatric orthopaedist, but for the well-being of our field.</p><p><strong>Key concepts: </strong>(1)Work-life balance correlates with interference with personal life, feeling valued by partners, autonomy and feeling supported when complications occur.(2)Job satisfaction is multifactorial with compensation not necessarily correlating to job satisfaction.</p><p><strong>Level of evidence: </strong>5, Expert Opinion.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100140"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT and Google Gemini are Clinically Inadequate in Providing Recommendations on Management of Developmental Dysplasia of the Hip Compared to American Academy of Orthopaedic Surgeons Clinical Practice Guidelines.","authors":"Patrick P Nian, Amith Umesh, Ruth H Jones, Akshitha Adhiyaman, Christopher J Williams, Christine M Goodbody, Jessica H Heyer, Shevaun M Doyle","doi":"10.1016/j.jposna.2024.100135","DOIUrl":"10.1016/j.jposna.2024.100135","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Large language models, including Chat Generative Pre-trained Transformer (ChatGPT) and Google Gemini have accelerated public accessibility to information, but their accuracy to medical questions remains unknown. In pediatric orthopaedics, no study has utilized board-certified expert opinion to evaluate the accuracy of artificial intelligence (AI) chatbots compared to evidence-based recommendations, including the American Academy of Orthopaedic Surgeons clinical practice guidelines (AAOS CPGs). The aims of this study were to compare responses by ChatGPT-4.0, ChatGPT-3.5, and Google Gemini with AAOS CPG recommendations on developmental dysplasia of the hip (DDH) regarding accuracy, supplementary and incomplete response patterns, and readability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;ChatGPT-4.0, ChatGPT-3.5, and Google Gemini were prompted by questions created from 9 evidence-based recommendations from the 2022 AAOS CPG on DDH. The answers to these questions were obtained on July 1st, 2024. Responses were anonymized and independently evaluated by two pediatric orthopaedic attending surgeons. Supplementary responses were additionally evaluated on whether no, some, or many modifications were necessary. Readability metrics (response length, Flesch-Kincaid reading level, Flesch Reading Ease, Gunning Fog Index) were compared. Cohen's Kappa inter-rater reliability (κ) was calculated. Chi-square analyses and single-factor analysis of variance were utilized to compare categorical and continuous variables, respectively. Statistical significance was set with &lt;i&gt;P&lt;/i&gt; ​&lt; ​0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;ChatGPT-4.0, ChatGPT-3.5, and Google Gemini were accurate in 5/9, 6/9, 6/9, supplementary in 8/9, 7/9, 9/9, and incomplete in 7/9, 6/9, 7/9 recommendations, respectively. Of 24 supplementary responses, 5 (20.8%), 16 (66.7%), and 3 (12.5%) required no, some, and many modifications, respectively. There were no significant differences in accuracy (&lt;i&gt;P&lt;/i&gt; ​= ​0.853), supplementary responses (&lt;i&gt;P&lt;/i&gt; ​= ​0.325), necessary modifications (&lt;i&gt;P&lt;/i&gt; ​= ​0.661), and incomplete responses (&lt;i&gt;P&lt;/i&gt; ​= ​0.825). κ was highest for accuracy at 0.17. Google Gemini was significantly more readable in Flesch-Kincaid reading level, Flesch Reading Ease, and Gunning fog index (all, &lt;i&gt;P&lt;/i&gt; ​&lt; ​0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In the setting of DDH, AI chatbots demonstrated limited accuracy, high supplementary and incomplete response patterns, and complex readability. Pediatric orthopaedic surgeons can counsel patients and their families to set appropriate expectations on the utility of these novel tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key concepts: &lt;/strong&gt;(1)Responses by ChatGPT-4.0, ChatGPT-3.5, and Google Gemini were inadequately accurate, frequently provided supplementary information that required modifications ​and frequently lacked essential details from the AAOS CPGs on DDH.(2)Accurate, supplementary, and incomplete response patterns were not sig","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100135"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intranasal Testing and Treatment for <i>Staphylococcus aureus</i> With Intravenous Vancomycin and Intranasal Povidone-iodine Prior to Posterior Spinal Fusion: A Retrospective Cohort Study Between Two High-volume Children's Hospitals.","authors":"Jason Malone, Alex Lee-Norris, Austin Wynn, Kaitlin Maher, John Lovejoy, Ryan Illgenfritz, Margaret Baldwin, Adriana Cadilla, Kathryn Farrell, Emily Craver","doi":"10.1016/j.jposna.2024.100136","DOIUrl":"10.1016/j.jposna.2024.100136","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The impact of surgical site infections in spinal surgery can be profound. Several studies have demonstrated that &lt;i&gt;S. aureus&lt;/i&gt; carriers have an increased risk of surgical site infection (SSI). The current literature shows decreased SSI in the adult population with povidine-iodine (PI) nasal treatment for decolonizing the nares of patients infected with &lt;i&gt;S. aureus&lt;/i&gt;. The goal of this research study was to analyze the isolated effect of presurgical &lt;i&gt;S. aureus&lt;/i&gt; nasal testing and PI application prior to spinal surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective cohort study of children 8 to 18 years of age who underwent posterior spinal fusion from 2018 to 2020 at two standalone academic pediatric hospitals. Both hospitals had the same preoperative surgical bundle except that Group B included testing for &lt;i&gt;S. aureus&lt;/i&gt; and treatment preoperatively if positive. In addition, all patients in Group B received PI nasal decolonization on the day of surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The overall infection rate between both hospitals was identified as 3.4%, with no difference between the two groups. The infection rate was lowest for adolescent idiopathic scoliosis, with a rate of 1.3% and highest for neuromuscular scoliosis, with a rate of 8.2%. Hospital-wide bacterial rates in Group A compared to Group B were higher for all &lt;i&gt;S. aureus&lt;/i&gt; species (33.8% vs 30.1%, &lt;i&gt;P&lt;/i&gt; ​= ​0.0004), methicillin-sensitive &lt;i&gt;S. aureus&lt;/i&gt; (24.6% vs 13.1 %, &lt;i&gt;P&lt;/i&gt; ​&lt; ​0.001) but lower for methicillin-resistant &lt;i&gt;S. aureus&lt;/i&gt; (9.2% vs 17%, &lt;i&gt;P&lt;/i&gt; ​= ​0.02). Postoperative infection culture rates or bacterium types were not significantly different between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The treatment of patients with PI nasal decolonization in the pediatric spinal fusion cohort did not show a decrease in postoperative infections. The PI nasal testing and treatment was $308.25 per patient and $189,580.75 over the study period. Elimination of intranasal testing and &lt;i&gt;S. aureus&lt;/i&gt; treatment result in cost savings and eliminates an unpleasant patient experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key concepts: &lt;/strong&gt;(1)The treatment of patients with povidine-iodine (PI) nasal decolonization in a pediatric spinal fusion cohort did not show a decrease in postoperative infections.(2)Elimination of intranasal testing and &lt;i&gt;Staphylococcus aureus&lt;/i&gt; treatment in a pediatric spinal fusion cohort results in cost savings and reduces an unpleasant experience for the patient.(3)Increased surgical time during posterior spinal fusion in a pediatric cohort of patient did not lead to an increased rate of surgical site infection (SSI).(4)Across the cohort of pediatric patient undergoing posterior spinal fusion (PSF), the rate of infection for adolescent idiopathic scoliosis (AIS) patients was 1.3% compared with 8.2% infection rate in patients with neuromuscular scoliosis (NMS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence: &lt;/strong","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100136"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of a Dedicated Orthopaedic Trauma Room for Children With Fractures of the Femur Treated at a Pediatric Community Hospital.","authors":"Jennifer A Sheasley, Anna Faino, Apeksha Gupta, Viviana Bompadre, Gregory A Schmale","doi":"10.1016/j.jposna.2024.100137","DOIUrl":"10.1016/j.jposna.2024.100137","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The benefits of a dedicated orthopaedic trauma room (DOTR) for patients with isolated femur fractures have not been reported from a pediatric community hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-three years of skeletally immature patients treated for an isolated diaphyseal femur fracture with two flexible intramedullary nails, Pre-DOTR: 2000-2015 and Post-DOTR: 2016-2022, were reviewed for comparison of patient demographics and injury patterns, timing and durations of surgery, fellow presence, duration and cost of hospitalization, and complication rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One hundred fifty-three patients were identified. One hundred twenty-six patients underwent surgery pre-DOTR and 27 post-DOTR. Demographics were similar between groups, except the post-DOTR patients were younger (mean age 7.4 years vs 9.0 years, &lt;i&gt;P&lt;/i&gt; ​= ​0.002). There was no significant difference in the percentage of patients undergoing surgery within 18 ​h of admission pre- and post-DOTR (78% vs 93%, respectively, &lt;i&gt;P&lt;/i&gt; ​= ​0.53). Post-DOTR surgeries were more frequently daytime (93%) than pre-DOTR (56%, &lt;i&gt;P&lt;/i&gt; ​&lt; ​0.001). Fellows were present in 8% of pre-DOTR vs 44% of post-DOTR procedures (&lt;i&gt;P&lt;/i&gt; ​&lt; ​0.0001). Average durations of surgery post-DOTR were significantly longer (118 ​min vs 93 ​min, &lt;i&gt;P&lt;/i&gt; ​= ​0.031). Lengths of stay post-DOTR were significantly shorter (3.0 days vs 3.5 days, &lt;i&gt;P&lt;/i&gt; ​= ​0.016), with substantial potential cost savings. There was no significant difference in complication rates pre- and post-DOTR (21% and 22%, &lt;i&gt;P&lt;/i&gt; ​= ​0.85).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Implementing a guaranteed first start for orthopaedic trauma via a DOTR at a pediatric community hospital, a pediatric non-Level I or II trauma center, allowed for daytime surgery without prolonging hospital stays for pediatric patients undergoing flexible intramedullary nailing for a femur fracture. Guaranteed morning OR block time for orthopaedic trauma decreased lengths of hospital stay and enabled a larger percentage of surgeries to be done during daytime hours. Shorter hospital stays suggest substantial cost savings, while early daytime surgery for nonemergent procedures avoided burdening families with prolonged waits to surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key concepts: &lt;/strong&gt;(1)A daily dedicated orthopaedic trauma room (DOTR) for operative treatment of orthopaedic trauma in a pediatric community hospital results in the vast majority of femur fracture surgeries being performed during daytime hours.(2)Even with a delay of many femur fracture surgeries until the next morning, a DOTR does not increase the fraction of patients treated outside the 18-h window from admission.(3)A DOTR for operative treatment of pediatric femur fractures in a community pediatric hospital can decrease lengths of stay for patients treated for diaphyseal femur fractures.(4)A DOTR may decrease the costs of hospitalization by decreasing lengths of stay fo","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100137"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Treatment of Supracondylar Humerus Fractures Requiring Transfer Between Facilities.","authors":"Shrey Nihalani, Harrison Reeves, Pearce Lane, Mack Padgett, Gerald Mcgwin, Michael J Conklin, Kevin A Williams","doi":"10.1016/j.jposna.2024.100141","DOIUrl":"10.1016/j.jposna.2024.100141","url":null,"abstract":"<p><strong>Purpose: </strong>The current study aims to elucidate the differences in the timing of the management of operative supracondylar humerus fractures (SCHF) based on whether or not the patient is transferred between facilities.</p><p><strong>Methods: </strong>This was a prospective cohort study of patients with surgically treated SCHF conducted at a level I pediatric trauma center. The management of these fractures was compared based on their presenting facility (pediatric trauma center versus another facility). Primary outcomes were time to orthopaedic consult, time to surgery, need for open reduction, and operative times. Secondary outcomes include the need for repeat imaging, transfer time, transfer vehicle, and transfer distance.</p><p><strong>Results: </strong>A total of 146 (78 female) patients with an average age of 5.70 (±2.12) years were included in the study. Time from initial presentation to orthopaedic consult (<i>P</i> ​< ​0.001) and time from initial presentation to surgery (<i>P</i> ​= ​0.006) was shorter for Children's hospital patients compared to outside facility patients. Repeat radiographs were more common when patients presented to outside facilities compared to children's hospital (<i>P</i> ​< ​0.001). Operative times were the same for both groups (31 ​min children's hospital, 32 ​min outside facility). Patients arriving from the outside facility via ambulance traveled further in comparison to those arriving via private vehicle (<i>P</i> ​= ​0.009) but had a shorter time to operation (<i>P</i> ​= ​0.002).</p><p><strong>Conclusions: </strong>Efficient processes and collaboration between healthcare facilities to ensure timely and effective care for pediatric patients with SCHF are essential. Patients from outside facilities experienced longer times to orthopaedic consult and surgery while having similar baseline characteristics.</p><p><strong>Key concepts: </strong>(1)Patients arriving from outside facilities had an overall longer time to orthopaedic consult and definitive fixation.(2)There was no difference in the need for open reduction or the operative time based on the patient's presenting facility.(3)Transferred patients often underwent repeat imaging prior to consult.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100141"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Women in ORTHopaedics Program Offers Early Exposure to Orthopaedic Surgery for Young Women. A Pre- and Post-Event Survey Comparison.","authors":"Marianna Hsu, Hayley Spurr, Anthony P Cooper, Emily K Schaeffer","doi":"10.1016/j.jposna.2024.100139","DOIUrl":"10.1016/j.jposna.2024.100139","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the medical field has made significant progress toward promoting gender equality. Despite this progress, orthopaaedic surgery remains the least diverse specialty among other surgical specialties. In response, our Department of Orthopaedics developed a specialized orthopaedic curriculum, Women in ORTHopaedics (WORTH), tailored specifically for young women in high school. This program offers early exposure and mentorship opportunities within the orthopaedic field.</p><p><strong>Methods: </strong>Participants were asked to complete a preliminary survey prior to the workshop. Subsequently, a corresponding survey was administered following the workshop, mirroring the questions from the pre-event survey. Participants shared their impressions of orthopaedics, interest in pursuing a career in this field, and awareness of available career pathways within this specialty.</p><p><strong>Results: </strong>In both workshops, the consensus among participants in the pre-event surveys included a sense of novelty and a desire to learn more about orthopaedics. However, post-workshop responses revealed a shift in perceptions, with participants expressing that orthopaedics encompasses a much broader array of subjects than initially expected. A comparison between pre- and post-survey responses indicates a heightened interest in pursuing a career in orthopaedics following the workshop. Additionally, 100% of attendees expressed their intention to participate in future WORTH events.</p><p><strong>Conclusions: </strong>Findings indicate that WORTH played a constructive role in guiding young women toward trajectories beyond secondary education. Additionally, it provided insights into the multitude of career options available in Orthopaedics apart from surgery, including physiotherapy, occupational therapy, nursing, research, and biomedical engineering.</p><p><strong>Key concepts: </strong>(1)Early exposure and mentorship allow for increased representation and retention of women in orthopaedics.(2)Representation of women in orthopaedics improves patient care and contributes to a more holistic approach to healthcare.(3)Outreach initiatives influence participants' interest and perceptions of pursuing a career in orthopaedics.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"10 ","pages":"100139"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to 'Tutorial on the treatment of the upper extremity in hemiplegic cerebral palsy: An expert panel case review' [Journal of the Pediatric Orthopaedic Society of North America 5, (2023) 653].","authors":"Carley Vuillermin, Marybeth Ezaki, Douglas T Hutchinson, Matthew Konigsberg, Ann Van Heest","doi":"10.1016/j.jposna.2024.100127","DOIUrl":"https://doi.org/10.1016/j.jposna.2024.100127","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.55275/JPOSNA-2023-653.].</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"9 ","pages":"100127"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building High-performance Teams in Pediatric Orthopaedic Surgery: The Importance of Psychological Safety and Creating a Trusting Environment.","authors":"Steven L Frick, Virginia F Casey, Benjamin J Shore, Peter M Waters","doi":"10.1016/j.jposna.2024.100132","DOIUrl":"10.1016/j.jposna.2024.100132","url":null,"abstract":"<p><p>Pediatric orthopaedic surgeons are the central figures in the delivery of specialized musculoskeletal care for children. Our work transcends individual skills, relying heavily on high-performance teams (HPTs) of professionals who deliver care cohesively across ambulatory clinics, hospital, and operating room settings. Furthermore, collaboration with hospital administrators is essential to secure the people, buildings, equipment, and resources for successful long-term patient care strategies. Thus, every pediatric orthopaedic surgeon needs to develop leadership skills that facilitate optimal patient care by creating a work environment that promotes peak performance by all team members. This article explores the foundational elements necessary to build and sustain HPTs in pediatric orthopaedic surgery, with a particular emphasis on psychological safety and trust. We will also provide recommendations for promoting a culture of excellence and mutual care.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"9 ","pages":"100132"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Birth Fractures.","authors":"Tyler C McDonald, C Lake Higdon, William A Cutchen","doi":"10.1016/j.jposna.2024.100131","DOIUrl":"10.1016/j.jposna.2024.100131","url":null,"abstract":"<p><p>Fractures in newborn infants due to trauma imparted by the birthing process are rare. These skeletal injuries can occur in the form of diaphyseal fractures or, much less commonly, separation of physes. Often, prompt recognition of birth fractures is difficult, which may lead to late presentation. Careful and thorough physical examination can identify the presence of these injuries, leading to appropriate treatment. Diaphyseal fractures can be treated non-operatively with light immobilization and comfort measures, with an excellent prognosis. Physeal injuries more often require surgical treatment to stabilize the displaced epiphyseal fragment after restoring anatomy. This review is designed for the orthopaedic clinician as an overview of the most commonly encountered varieties of these rare birth fractures so that they may be better equipped to recognize, diagnose, and offer appropriate treatment.</p><p><strong>Key concepts: </strong>(1)Fractures and physeal separations sustained from birth trauma are rare and often require a high index of suspicion for diagnosis.(2)The overwhelming majority of diaphyseal fractures sustained from birth trauma can be treated nonoperatively with an excellent prognosis.(3)Physeal separations can be easily confused with other diagnoses, such as joint dislocations, and more often require surgical intervention for stabilization.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"9 ","pages":"100131"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}