Today’s Top Story
Study: Some healthcare providers skip recommended nonaccidental trauma evaluations for pediatric femur fracture patients.
Findings from a study published online in the Journal of Pediatric Orthopaedics suggest that many healthcare providers may not conduct recommended nonaccidental trauma (NAT) evaluations for young femur fracture patients. The authors conducted a retrospective review of 281 pediatric patients younger than 36 months. They found that overall, 41 percent were evaluated for NAT. Overall, younger age, transfer from an outside facility, and identification of another fracture were significantly associated with receipt of a NAT evaluation, but fracture pattern and patient sex were not. Prior to publication of an AAOS clinical practice guideline (CPG) on treatment of pediatric diaphyseal femur fractures, 43 percent of nonwhite patients and 19 percent of white patients underwent NAT evaluation, compared to 43 percent and 47 percent respectively after publication. Read the abstract…
Read the AAOS CPG, “Treatment of Pediatric Diaphyseal Femur Fractures”…
Other News
AHRQ scorecard finds incidence of HACs on the decline.
A scorecard released by the U.S. Agency for Healthcare Research and Quality (AHRQ) finds that 125,000 fewer patients died due to hospital-acquired conditions (HACs) and more than $28 billion in healthcare costs were saved from 2010 through 2015. The scorecard notes a 21 percent decline in the rate of HACs over that period. Read more…
View the scorecard…
Study: Should younger TKA patients be cautioned about increased risk of dissatisfaction?
Data from a study conducted in the United Kingdom and published online in The Bone & Joint Journal suggest that patients younger than 55 years who undergo total knee arthroplasty (TKA) should be informed regarding an increased risk of dissatisfaction. The research team conducted a prospective study of 157 patients (177 TKAs) aged 17 to 54 years. They found that 44 patients (24.9 percent [44 TKAs]) were unsure or dissatisfied with their knee. Based on univariate analysis, significant predictors of dissatisfaction included Kellgren-Lawrence grade 1/2 osteoarthritis, poor pre-operative Oxford Knee Score (OKS), complications, poor improvements in Short Form-12 physical component score and OKS, and indication. Based on multivariate analysis, poor pre-operative OKS, poor improvement in OKS, and post-operative stiffness independently predicted dissatisfaction. Read the abstract…
Study: What factors may affect early outcomes following CR for infantile developmental dysplasia of the hip?
A study published online in the Journal of Pediatric Orthopaedics examines factors that may affect early outcomes following closed reduction (CR) for infantile developmental dysplasia of the hip. The researchers conducted an observational, prospective study of 78 patients (87 hips) with a median age of 8 months who underwent CR. Overall, eight hips were unable to be reduced initially. At median 22-month follow-up, the researchers found that 9 percent (72 of 79) of initially successful CRs remained stable, and of those, 25 percent (18 of 72) developed radiographic avascular necrosis (AVN). They noted no significant association between likelihood of failure and initial clinical reducibility of the hip, age at initial CR, or previous treatment in brace. Risk of osteonecrosis was not associated with prereduction reducibility of the hip, age at CR, presence of an ossific nucleus, or previous treatment in brace. The researchers write that further follow-up is necessary to establish definitive success and complication rates following CR for infantile developmental dysplasia of the hip. Read the abstract…
OIG report recommends increased scrutiny of facilities with increasing numbers of potentially inappropriate short inpatient stays.
A report released by the U.S. Department of Health and Human Services Office of Inspector General (OIG) recommends that the U.S. Centers for Medicare & Medicaid Services analyze hospital billing and target for review facilities with high or increasing numbers of short inpatient stays that may be inappropriate under the so-called 2-midnight policy, which establishes that inpatient payment is generally appropriate if physicians expect beneficiaries’ care to last at least 2 midnights. The report finds that, since implementation of the 2-midnight policy, the number of inpatient stays has decreased and the number of outpatient stays has increased. However, the report finds that hospitals continue to vary in how they use inpatient and outpatient stays, and suggests that hospitals may be billing for many short inpatient stays that are potentially inappropriate under the policy. Read more…
Read the report (PDF)…
Study: Lifestyle may be factor in resident attrition.
A study published online in the journal JAMA Surgery examines attrition rates for general surgery programs and finds wide discrepancies in the prevalence and causes of attrition reported among surgical residents. The research team conducted a meta-analysis of 22 studies covering 19,821 residents. They found that the pooled estimate for overall attrition was 18 percent, with significant variation between studies. Departing residents often relocated to another general surgery program, or switched to other specialties. The most common reported causes of attrition were uncontrollable lifestyle and transferring to another specialty. Read the abstract…
Call for volunteers: OKU Evaluation Committee.
Dec. 27 is the last day to submit your application for a position on the OKU Evaluation Committee (one member opening—oncology). The OKU Evaluation Committee is responsible for development and review of the Orthopaedic Knowledge Update (OKU) Self-Assessment Examination. Applicants for this position must be active or emeritus fellows with a broad practice emphasis in oncology. Learn more and submit your application…(member login required)
Note: The AAOS offices will be closed on Dec. 23, Dec. 26, and Jan. 2. AAOS Headline News Now will not be published Dec. 23 through Jan. 2. It will return on Wednesday, Jan. 4, 2016.
