Are There Gender Differences Among Leaders of Regional Orthopaedic Societies of the United States?

BACKGROUND: Great efforts are currently being made toward improving gender and racial equity in orthopaedic surgery in the United States. Nonetheless, no research has reported on whether these efforts have increased representation of women and underrepresented minorities in leadership roles in orthopaedic surgery societies. QUESTIONS/PURPOSES: Are women proportionally represented in the leadership of regional orthopaedic societies in the United States? METHODS: The latest version of the American Association of Orthopaedic Surgeons census data was evaluated to determine the numbers (and percentages) of women and men practicing orthopaedic surgery in the United States. We also queried data for regional orthopaedic societies members who held a position of leadership (four societies; n = 53) between 2012 and 2017. Collected data included gender, years of experience, and practice setting. A chi-square analysis was conducted to compare the percentage of women in leadership with the percentage of women in practice in each of four geographic regions (Western Orthopaedic Association [WOA]; Southern Orthopaedic Association [SOA]; Eastern Orthopaedic Association [EOA]; Mid-America Orthopaedic Association [MAOA]) to see if the representation of women was proportional to that of men. RESULTS: With the numbers available, there was no difference in the observed-to-expected proportions between men and women in leadership in any of the regional societies we studied For the eastern region, there were 6% (392 of 6514) versus 0% (0 of 12; p = 0.591) of practicing women orthopaedic surgeons versus women orthopaedic surgeons holding positions in EOA leadership. For the Western region, there were 5% (304 of 5744) versus 7% (1 of 14; p = 0.836) practicing women orthopaedic surgeons versus women orthopaedic surgeons holding positions in WOA leadership. For the Midwest United States region, there were 6% (443 of 6937) versus 0% (0 of 15; p = 0.509) of practicing women orthopaedic surgeons versus women orthopaedic surgeons holding positions in MAOA leadership. For the Southern United States region, there were 4% (443 of 9601) versus 0% (0 of 13; p = 0.662) of practicing women orthopaedic surgeons versus women orthopaedic surgeons holding positions in SOA leadership. CONCLUSIONS: We found that women were represented in leadership roles in the regional societies in the United States in proportion to their overall numbers. However, that overall number was small, and so the percentages of regional society leaders who were women were correspondingly small. CLINICAL RELEVANCE: The low number of women orthopaedic surgeons holding leadership positions in regional societies are most likely a function of the low overall number of women orthopaedic surgeons, but focused efforts to change the status quo may increase the diversity of leadership in these societies.

Treatment of Peritrochanteric Femur Fractures With Proximal Femur Locked Plating.

OBJECTIVES: To report on our results using a proximal femoral locking plate for the treatment of peritrochanteric femur fractures. DESIGN: Retrospective study. SETTING: Level I Academic Medical Center. PATIENTS: Sixty-eight patients with 68 fractures. INTERVENTION: Demographics, fracture morphology, preoperative imaging, rationale against nailing, and outcomes were collected. MAIN OUTCOME MEASUREMENTS: Outcomes were grouped into no complication, minor complication, or major complication. Minor complications included healed fractures with implant failure or change in alignment from immediate postoperative radiographs, which did not require intervention or elective implant removal. Major complications included any case that required revision for nonunion or implant failure. RESULTS: Nine patients were lost to follow-up. Of the 59 fractures, 16 had complications (27%): 9 minor and 7 major. Active tobacco use (P = 0.020) and fractures with an associated intracapsular femoral neck component (P = 0.006) correlated with complications. CONCLUSIONS: Proximal femoral locking plates continue to be associated with a high complication rate. However, based on our experience, proximal femoral locking plates may be considered in highly selected cases when absolutely no other implant is deemed appropriate, based on the degree of comminution and the complexity of the fracture pattern. Patients must be informed about the possibility of revision surgery based on the inherent limitations of these devices. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.