BackgroundSocio-demographic factors have been suggested to contribute to differences in healthcare utilization for several elective orthopedic procedures. Reports on disparities in utilization of orthopedic trauma procedures remain limited. The purpose of our study is to assess the roles of clinical and socio-demographic variables in utilization of operative fixation of calcaneus fractures in the USA.MethodsThe National Inpatient Sample (NIS) dataset was used to analyze all patients from 2005 to 2014 with closed calcaneal fractures. Multivariate logistic regression analyses were performed to evaluate the impact of clinical and socio-demographic variables on the utilization of surgical versus non-surgical treatment.ResultsA total of 17,156 patients with closed calcaneus fractures were identified. Operative treatment was rendered in 7039 patients (41.03%). A multivariate logistic regression demonstrated multiple clinical and socio-demographic factors to significantly influence the utilization of surgical treatment including age, gender, insurance status, race/ethnicity, income, diabetes, peripheral vascular disease, psychosis, drug abuse, and alcohol abuse (p <  0.05). In addition, hospital size and hospital type (teaching versus non-teaching) showed a statistically significant difference (p <  0.05).ConclusionsBesides different clinical variables, we identified several socio-demographic factors influencing the utilization of surgical treatment of calcaneus fractures in the US patient population. Further studies need to identify the specific patient-related, provider-related, and system-related factors leading to these disparities.

The SoMe adopted, while varied, allowed for increased, and different forms of, information delivery by HEMS to the public, often in real time. Such use, though, risks breaching patient confidentiality and data protection requirements, especially when information is viewed cumulatively across platforms. There is an urgent need for the continued development of guidance in this unique setting to protect patients while UK HEMS promote and fundraise for their charitable activities.

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Objectives To assess a possible association between UAC and Trisomy 21. Method Medical records of all women undergoing amniocentesis between April 2008 and October 2012 at RDH were analysed highlighting UAC and karyotype result. Results 425 women underwent amniocentesis for standard screening rationale. 33 fetuses were diagnosed with trisomy 21, (incidence of 7.6%). 21 women had their amniocentesis delayed because of UAC (404 did not as the membranes were normally fused - NFM). Of these, 10 had a result confirming the presence of Trisomy 21, the remaining 11 had a normal result, 23 of the 404 with NFM had Trisomy 21. Abstract PF.42 Table Down’s present Down’s absent Total UAC 10 11 21 NFM 23 381 404 33 392 425 Sensitivity of UAC = 10/33 = 30.3% Specificity of UAC = 381/392 = 97.2% PPV = 10/21 = 47.6% NPV = 381/404 = 94.3% Conclusion We suggest that NFM has a negative association with Trisomy 21 with high NPV and may be helpful in counselling. Furthermore UAC seems to be only associated with Trisomy 21 and no other chromosomal abnormality in this population. We suggest further prospective study of this phenomenon. Abnormalities of cell adhesion molecules (encoded on C21) are well described in Down’s (DSCAM – Down’s Cell Adhesion Molecule) and this suggests a possible aetiology.

Background: Hispanics represent the largest minority group in the United States and are projected to represent 29% of the US population by 2060. Enrolling Hispanic patients in clinical outcome trials is critical to study a representative sample of the general population. Lack of translated and validated survey tools has been identified as a major barrier to enrolling Spanish speaking patients. The purpose of this validation study was to study the correlation between the Spanish translation of the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes questionnaire (AAOS-FAOQ) and the Spanish versions of the Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ) in Hispanics from Mexican lineage with traumatic foot and ankle injuries. Methods: A cross-sectional validation study in 36 Hispanic patients from Mexican lineage with foot and ankle injuries was performed. The Hispanic version of the AAOS-FAOQ and the Spanish translations of the FAOQ, FHSQ, FFI, and the Short-Form 36 questionnaire (SF-36) were distributed among all patients. Subsequent statistical analysis correlating the Hispanic version of the AAOS-FAOQ to the FFI, FHSQ, and SF-36 was performed. Additional analysis on the Hispanic AAOS-FAOQ included test–retest reliability and internal consistency. Results: The Hispanic AAOS-FAOQ Global Foot and Ankle subscale showed statistically significant ( P < .05) correlations with 5 of 8 subscales of the FHSQ, the FFI, and the Physical Component Summary subscale of the SF-36. The AAOS-FAOQ Global Foot & Ankle Scale also demonstrated a test–retest reliability of 0.736 and a strong internal consistency. Conclusions: This study further validates AAOS-FAOQ in Mexican Hispanics by showing strong correlations with the validated Spanish versions of the FFI and FHSQ.