过去十年间小儿骨科外科医生的实践变化：美国骨科手术委员会数据库分析

Changes in the Practice of Pediatric Orthopaedic Surgeons Over the Past Decade: Analysis of the Database of the American Board of Orthopaedic Surgery.

作者信息

Hosseinzadeh Pooya, DeVries Clarabelle A, Nielsen Ena, Andras Lindsay A, Mignemi Megan, Sawyer Jeffrey R, Flynn John M, Albanese Stephen A

机构信息

Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

Children's Hospital of Los Angeles, Los Angeles, CA.

出版信息

J Pediatr Orthop. 2018 Sep;38(8):e486-e489. doi: 10.1097/BPO.0000000000001214.

DOI:10.1097/BPO.0000000000001214

PMID:29917007

Abstract

BACKGROUND

There has been an increase in the number of the graduates of pediatric orthopaedic fellowship programs over the past decade creating the potential for increased competition in the field. The purpose of this study was to analyze the effect of increased number of pediatric orthopaedic fellowship graduates on case volume as well as the type of procedures performed by recent graduates of pediatric orthopaedic fellowship programs from 2004 to 2014.

METHODS

Case logs submitted for the American Board of Orthopaedic Surgery Part II examination by applicants with the self-declared subspecialty of pediatric orthopaedics from 2004 to 2014 were analyzed. Cases were categorized as trauma (upper and lower extremity), spine, sports medicine, hip, deformity correction, foot and ankle, hardware removal, soft tissue procedures, and other. The period was divided into 3 sections: 2004-2007, 2008-2011, 2012-2014. Descriptive analysis was used to report the change in the volume and pattern of practices over the study period.

RESULTS

Although the number of pediatric orthopaedic subspecialty applicants increased from 15 to 44 from 2004 to 2014, the average cases per year increased from 2142 in 2004-2007 to 2960 in 2007-2011, and to 4160 in 2012-2014. The number of cases performed per applicant remained stable over the study period. Upper extremity trauma cases were the largest category of cases reported and increased in case volume by 141% from 2004 to 2014. Sports medicine cases increased in volume by 175%.

CONCLUSIONS

Despite a large increase in the number of pediatric orthopaedic surgeons over the past decade, there is a concomitant increased in case volume across almost all subspecialties within pediatric orthopaedics. As such, pediatric orthopaedic surgeons who start a new practice can expect to develop a robust practice with a diverse group of pathologies.

LEVEL OF EVIDENCE

Level III.

摘要

背景

在过去十年中，小儿骨科 fellowship 项目的毕业生数量有所增加，这使得该领域的竞争有加剧的可能。本研究的目的是分析小儿骨科 fellowship 毕业生数量增加对病例数量的影响，以及 2004 年至 2014 年小儿骨科 fellowship 项目近期毕业生所实施手术的类型。

方法

对 2004 年至 2014 年自我申报小儿骨科亚专业的申请人提交给美国骨科手术委员会第二部分考试的病例记录进行分析。病例分为创伤（上肢和下肢）、脊柱、运动医学、髋关节、畸形矫正、足踝、内固定取出、软组织手术及其他。该时期分为三个阶段：2004 - 2007 年、2008 - 2011 年、2012 - 2014 年。采用描述性分析来报告研究期间手术量和手术模式的变化。

结果

尽管 2004 年至 2014 年小儿骨科亚专业申请人数量从 15 人增加到 44 人，但每年的平均病例数从 2004 - 2007 年的 2142 例增加到 2007 - 2011 年的 2960 例，再到 2012 - 2014 年的 4160 例。每位申请人的手术病例数在研究期间保持稳定。上肢创伤病例是报告的最大病例类别，从 2004 年到 2014 年病例量增加了 141%。运动医学病例量增加了 175%。