Today’s Top Story
Study: How do outcomes compare for surgical and nonsurgical treatment of displaced midshaft clavicle fracture?
A study published in the July 19 issue of The Journal of Bone & Joint Surgery compares surgical and nonsurgical treatment approaches for displaced midshaft clavicle fracture. The authors conducted a prospective, randomized, controlled trial of 117 patients who received either nonsurgical treatment with a figure-of-eight harness or surgical treatment with anteroinferior plate osteosynthesis. At 6-week, 6-month, and 1-year follow-ups, they found no difference across cohorts in Disabilities of the Arm, Shoulder and Hand score, visual analog scale pain level, time to return to previous activities, or cosmetic dissatisfaction. However, the authors note that seven nonsurgical patients (14.9 percent) developed nonunion, compared to none in the surgical group. Further, nonsurgically treated patients displayed radiographic evidence of greater clavicle shortening compared with those in the surgical cohort, and more patients in that group answered “yes” when asked if their clavicle felt short and if they felt bone prominence. In the surgical group, more patients answered “yes” when asked if they felt paresthesia. Read the abstract…

Other News

Study: ACL reconstruction remains effective for many patients at 10 years.
Findings from a study presented at the annual meeting of the American Orthopaedic Society for Sports Medicine (AOSSM) suggest that many patients experience good quality of life in the long term following anterior cruciate ligament (ACL) reconstruction. The research team reviewed prospectively collected data on 1,320 ACL reconstruction patients from the Multicenter Orthopaedics Outcome Network study. They found that International Knee Documentation Committee score and Knee Injury and Osteoarthritis Outcome Score significantly improved after 2 years and were maintained at 6 and 10 years. The research team notes that significant drivers of poorer outcomes were lower baseline outcome scores; higher body mass index; smoker at baseline; history of medial meniscus surgery prior to ACL reconstruction; having a revision ACL reconstruction; grades 3-4 articular cartilage pathology in the medial, lateral, and patellofemoral compartments; and having any subsequent ipsilateral surgery. The research team states that graft type, medial collateral ligament or lateral collateral ligament pathology, and medial or lateral meniscus surgery at the time of ACL reconstruction were not found to be significant risk factors. Read more…
Read the abstract (PDF; paper 140)…

Study: What factors are linked to shoulder and elbow injury for baseball pitchers?
A paper presented at the AOSSM annual meeting examines risk factors for shoulder and elbow injuries among professional baseball pitchers. The researchers reviewed data on 132 pitcher-seasons played from 2010 to 2015, and found that 25 shoulder and 28 elbow injuries occurred during the study period. The most significant categorical risk factors associated with increased elbow injury rates included presence of a shoulder external rotation (ER) deficit >5° and shoulder flexion deficit >5°. For continuous variables, the most important factors included increasing shoulder ER deficit, decreased shoulder flexion increased internal rotation deficit, weight, and decreased shoulder ER. Read more…
Read the abstract (PDF; paper 113)…

Few physicians review their Open Payments records.
The California Medical Association notes that, according to information released by the U.S. Centers for Medicare & Medicaid Services (CMS), only 5.6 percent of the 630,824 physicians who received payments in 2016 registered to review their data on the CMS Open Payments system. The organization notes that, although the official review-and-dispute period ended on May 15, physicians can continue to review their records and dispute the data. Unresolved disputes or corrections will be reflected in the next scheduled database update. Read more…
Read the CMS fact sheet (PDF)…

Missouri
An article in Modern Healthcare reports that the governor of Missouri has signed an executive order to create a prescription drug monitoring program in that state. The writer notes that all states have now implemented programs to track prescription drug prescriptions as part of efforts to combat prescription opioid addiction and so-called doctor shopping. Read more…(registration may be required)

Comments sought for ASSH/AAOS performance measures for carpal tunnel syndrome.
Quality measures for treatment of carpal tunnel syndrome developed jointly by the American Society for Surgery of the Hand (ASSH) and AAOS are entering the public commentary stage. Public comments will be accepted through Monday, Aug. 21, 2017. Read more and submit comments (PDF)…

Call for volunteers: Opioid Stewardship Action Team.
AAOS seeks to nominate members to the Opioid Stewardship Action Team—a National Quality Forum (NQF) initiative to designed to address the escalating opioid epidemic. The team will identify strategies for managing care of individuals who may be at high risk of opioid dependence, and will advance quality measures that support providers and care of patients with chronic pain. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, and an online statement of interest on the NQF website. All supporting materials must be submitted by Aug. 2, 2017, at 11:59 p.m. CT, to Kyle Trivedi at: trivedi@aaos.org.
Learn more and submit your application…(member login required)
Learn more and submit your NQF statement of interest…

Call for volunteers: Diversity Advisory Board.
Aug. 1 is the last day to submit your application for a position on the Diversity Advisory Board. The Diversity Advisory Board provides resources to assist AAOS members in providing culturally competent care to diverse populations, and develops and implements strategies to overcome barriers faced by minorities when choosing orthopaedics as a career. The following positions are available:

  • Chair
  • Communications Cabinet liaison
  • Education Council liaison
  • Member-at-large

Applicants for the chair and liaison openings must be active fellows; applicants for the member-at-large opening must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, candidate member applicants for fellowship osteopathic, associate members orthopaedic, or associate members osteopathic. Learn more and submit your application…(member login required)