No abstract

Background: Fellowship directors in orthopaedic trauma surgery have an immense impact on the current and future trainees within orthopaedics. The purpose of our study was to evaluate and better understand the characteristics that are shared among current orthopaedic trauma surgery fellowship directors to provide a framework for aspiring leaders and to present a demographic snapshot. Methods: Orthopaedic trauma fellowship programs were identified using the Orthopaedic Trauma Association Directory for 2019 to 2020. Data for each fellowship director was gathered via online review, email, telephone, and curriculum vitae collection. Results: Demographic information was gathered for 72 fellowship directors. Of these, 93% of the leadership was male. Additionally, 40 (55%) fellowship directors responded to the racial classification question. Of those responding, 37 identified as Caucasian, one as Asian-American, one as Hispanic/Latino, and one as African American. The mean age of the current fellowship directors (51.4 yr), h-index (15.1), year of residency (2001) and fellowship (2003) graduation, time of employment at current institution (13.8 yr), time since training until fellowship director appointment (9.8 yr) were analyzed. The top residency and fellowship programs that produced future fellowship directors were University of Pittsburgh (n=4) and Harborview Medical Center (n=17). Conclusions: Our investigation highlighted the qualifications of orthopaedic trauma fellowship directors and can guide future leaders. A select few institutions train a disproportionate share of the current fellowship directors. Gender and racial diversity are limited in this population of leaders. Level of Evidence: Level III.

IntroductionRecent advances have led to the design of a new cephalomedullary nail, which aims to decrease the risk of failures in patients with intertrochanteric hip fractures by allowing for insertion of two interdigitating screws into the head segment. The goal of this study is to evaluate the safety and efficacy of this two-screw cephalomedullary nailing system.Patients/participantsPatients 18 years of age and older who underwent intramedullary nailing of their intertrochanteric femoral fracture using the InterTAN nailing system (Smith and Nephew, Memphis, TN) from 2012 to 2016 were included in this retrospective study which was performed at two urban certified level-1 trauma centers and one urban certified level-3 trauma center. The study data was collected through a retrospective chart review and review of the existing radiographic studies. Primary outcome measure was mechanical hardware failure and screw cutout. Secondary outcome measures included nonunion, malunion, medical and surgical complications.ResultsA total of 264 patients were included in this analysis. Two patients (0.75%) were found to have a screw cut out requiring revision surgery. Two other revision surgeries were performed for malrotation (n = 1) and malunion (n = 1). Other implant-related complications occurred in 19 cases (7.9%), which included broken distal screws (n = 9), distal screw loosening (n = 8), and loose lag screws (n = 2). There was a total of 10 (3.8%) surgical wound complications, including four deep and six superficial infections.DiscussionThis modified cephalomedullary nail is a reliable, safe, and effective implant for management of intertrochanteric hip fractures. Surgical treatment of patients with intertrochanteric hip fractures can be performed in a safe fashion using this implant.

Retrospective study, Level IV.