Aprato Alessandro, Audisio Andrea, Masoni Virginia, Guidetti Chiara, Artiaco Stefano, Massè Alessandro
Department of Surgical Sciences, University of Turin, 10124, Turin, Italy.
Pediatric Orthopaedics and Traumatology, Regina Margherita Children's Hospital, 10126, Turin, Italy.
Injury. 2025 Feb;56(2):112087. doi: 10.1016/j.injury.2024.112087. Epub 2024 Dec 27.
Several concerns regarding gender equality in orthopedic surgery do exists. The aim of this study was to (1) compare operative times, (2) compare mortality rates, (3) investigate gender disparities in hip fracture surgeries, and (4) analyze gender distribution among attending and resident surgeons performing Closed Reduction Internal Fixation (CRIF) and Hemiarthroplasty (HA) METHODS: All patients >75 years old treated for proximal femur fractures in a level-one trauma center in a four-year timeframe were retrospectively enrolled. Exclusion criteria were follow-up <3 years, incomplete data, active patients treated with total hip arthroplasty (THA) and other surgeries performed during the same anesthesia. Patients were grouped according to procedure: 1) Closed Reduction Internal Fixation (CRIF) and 2) Hemiarthroplasty (HA). Gender and level of expertise (residents or attending surgeon) of leading surgeons (male (M), female (F) and non-binary (NB)) was extracted from medical records. Operative time, mortality rates, and the likelihood of performing either CRIF or HA were compared across genders.
A total of 172 leading surgeons (M: 141 (82%); F: 31 (18%); NB: 0 (0%)) performed 1916 surgical procedures (CRIF: 1425 (74.4%); HA: 491 (25.6%)). 14.7% were performed by female surgeons (group 1: 15.5%; group 2: 12.2%; p = 0.076). No gender disparities were observed in the mean operating times for either group 1 (p = 0.759) or group 2 (p = 0.981). Similarly, there were no significant differences in mortality rates between genders in group 1 (p = 0.5779) or group 2 (p = 0.069). Additionally, no significant gender disparities were found in the performance of CRIF (p = 0.636) or HA (p = 0.141). Finally, analysis of gender distribution among attending and resident surgeons across various procedures, including CRIF and HA, revealed no significant differences in gender distribution (CRIF: p = 0.133, HA: p = 0.468, all procedures: p = 0.122).
Despite orthopedics still being a male-dominated field, gender does not affect surgical outcomes or the likelihood of performing CRIF or HA. However, the focus should shift towards improving inclusivity in surgical education and practice by providing equal opportunities and removing social and educational barriers based on gender.
骨科手术中的性别平等确实存在一些问题。本研究的目的是：（1）比较手术时间；（2）比较死亡率；（3）调查髋部骨折手术中的性别差异；（4）分析进行闭合复位内固定术（CRIF）和半髋关节置换术（HA）的主治医生和住院医生中的性别分布。方法：回顾性纳入在一家一级创伤中心四年时间内接受治疗的所有75岁以上股骨近端骨折患者。排除标准为随访时间<3年、数据不完整、接受全髋关节置换术（THA）治疗的活跃患者以及在同一麻醉期间进行的其他手术。患者按手术方式分组：1）闭合复位内固定术（CRIF）；2）半髋关节置换术（HA）。从病历中提取主刀医生（男性（M）、女性（F）和非二元性别（NB））的性别和专业水平（住院医生或主治医生）。比较不同性别的手术时间、死亡率以及进行CRIF或HA的可能性。
共有172名主刀医生（男性：141名（82%）；女性：31名（18%）；非二元性别：0名（0%））进行了1916例手术（CRIF：1425例（74.4%）；HA：491例（25.6%））。14.7%的手术由女性外科医生进行（第1组：15.5%；第2组：12.2%；p = 0.076）。第1组（p = 0.759）或第2组（p = 0.981）的平均手术时间均未观察到性别差异。同样，第1组（p = 0.5779）或第2组（p = 0.069）的性别间死亡率也无显著差异。此外，在进行CRIF（p = 0.636）或HA（p = 0.141）方面也未发现显著的性别差异。最后，对包括CRIF和HA在内的各种手术中主治医生和住院医生的性别分布分析显示，性别分布无显著差异（CRIF：p = 0.
