Department of Orthopaedics, The Medical College of Wisconsin, Wisconsin (AB).
Department of Orthopaedics, Penn State Bone and Joint Institute, Hershey, Pennsylvania (MCA, UA).
Foot Ankle Spec. 2021 Jun;14(3):206-212. doi: 10.1177/1938640020910951. Epub 2020 Mar 13.
Foot and ankle surgeries in the United States (US) are currently performed by orthopaedic surgeons or podiatrists with specialty surgical training. With the trend in healthcare now placing increased emphasis on quality and standardizing patient care, this study aimed to characterize the distribution, volume, and trends of certain foot and ankle surgeries performed in the US by both orthopaedic surgeons and podiatrists.
A retrospective analysis was performed using the Marketscan Claims Database (Truven Health Analytics, Ann Arbor, Michigan) which covers most privately insured patients under the age of 65 in the USA from 2005 to 2014. We searched current procedural terminology (CPT) codes for total ankle replacement (TAR), triple arthrodesis, hallux valgus correction, pilon fracture open reduction and internal fixation (ORIF), calcaneus fracture ORIF, and ankle fracture ORIF. We recorded the timing and nature of procedures along with various features associated with the surgeon and the geographic location of the treatment facility.
We found that the number of foot and ankle procedures performed annually is steadily increasing. Orthopaedic surgeons are the main treating surgeon for common foot and ankle traumatic conditions or complex hind foot cases like TAR. On the other hand, our study showed that podiatrists perform almost 9 out of 10 hallux valgus correction surgeries.
Our study showed the trends in surgical volumes and differences between surgical podiatrists and orthopaedic surgeons and the evolution of these volumes over a ten year period and differences in surgical repertoire between orthopaedists and podiatrists. Level IV: Case series, Clinical research.
目前，美国的足部和踝关节手术由具有专业外科培训的矫形外科医生或足病医生进行。随着医疗保健趋势现在更加注重质量和标准化患者护理，本研究旨在描述美国矫形外科医生和足病医生进行的某些足部和踝关节手术的分布、数量和趋势。
使用 Marketscan Claims Database（Truven Health Analytics，密歇根州安阿伯）进行回顾性分析，该数据库涵盖了美国 2005 年至 2014 年期间年龄在 65 岁以下的大多数私人保险患者。我们搜索了总踝关节置换术（TAR）、三关节融合术、拇外翻矫正术、跖骨骨折切开复位内固定术（ORIF）、跟骨骨折 ORIF 和踝关节骨折 ORIF 的当前程序术语 (CPT) 代码。我们记录了手术的时间和性质以及与外科医生和治疗设施地理位置相关的各种特征。
我们发现每年进行的足部和踝关节手术数量稳步增加。矫形外科医生是治疗常见足部和踝关节创伤性疾病或 TAR 等复杂后足病例的主要治疗外科医生。另一方面，我们的研究表明，足病医生几乎完成了 10 例拇外翻矫正手术中的 9 例。
我们的研究显示了手术量的趋势以及足病医生和矫形外科医生之间的手术差异，以及这些手术量在十年期间的演变以及矫形医生和足病医生之间的手术 repertoire 差异。四级：病例系列，临床研究。
