The Perception of Pregnancy and Parenthood Among Female Orthopaedic Surgery Residents.

INTRODUCTION: Orthopaedic surgery has the lowest percentage of female residents of all surgical specialties. Female medical students may believe that the demands of the specialty, both during training and in clinical practice, may be less conducive to becoming a parent. The purpose of this study was to determine the perceptions of and experiences with pregnancy and parenthood among female orthopaedic surgery trainees. METHODS: An anonymous 24-question online survey was distributed to all current female orthopaedic surgery trainees in the United States via the American Academy of Orthopaedic Surgeons Diversity Advisory Board. Survey questions included the demographics of the residents' programs, the parental status of the respondents, and their experiences with pregnancy and parenthood during training. RESULTS: Of the respondents, 83.7% did not have children during residency and were not currently pregnant. Furthermore, 48.4% responded that they had deferred having children because they were in residency. One hundred and thirteen respondents (59.5%) reported that they experienced bias from co-residents about women having children during residency, whereas 94 (49.5%) reported such bias from attendings. CONCLUSION: This study demonstrates that most female orthopaedic trainees do not have children during residency. Most respondents experienced bias from co-residents about women having children during residency, and nearly half experienced such bias from orthopaedic attendings. Combating bias about pregnancy during residency may help encourage more women to pursue a career in orthopaedics.

A Practical Analgesia Approach to Fragility Hip Fracture: A Single-Center, Retrospective, Cohort Study on Femoral Nerve Block.

OBJECTIVE: To determine whether an effective opioid-sparing pain control modality is desirable for an aging population. DESIGN: Retrospective observational study SETTING:: Academic medical center PATIENTS:: 192 patients with various types of fragility hip fractures INTERVENTION:: A single-injection femoral nerve block (FNB) MAIN OUTCOME MEASUREMENTS:: Pain score, opioid consumption RESULTS:: We observed statistically significant effects of FNB on visual analogue scale pain score and the rate of opioid consumption diminution in all commonly encountered types of fragility hip fractures. The pain score reduction by FNB in subcapital femoral neck fracture, transcervical femoral neck facture, and intertrochanteric fracture are all statistically significant (P < 0.0001). There was a statistically more significant pain score reduction in intracapsular fractures than in extracapsular fractures (P = 0.006). On average, the hip fracture patients required 0.9 and 0.1 mg morphine equivalent/hour before and after FNB block placement. This decrease in opioid consumption when calculated per unit time was statistically significant in subcapital femoral neck fracture, transcervical femoral neck facture, and intertrochanteric fracture (P < 0.0001). There were no complications related to FNB placement. CONCLUSIONS: FNB is a sustainable, safe, and useful analgesic modality for commonly encountered fragility hip fractures. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.