How are French pediatric orthopedic surgeons affected by burnout? Results of a nationwide survey.

INTRODUCTION: Burnout is a syndrome that adversely affects those who work in roles designed to assist and aid others, such as healthcare professionals. There is a paucity of data available on this topic among French pediatric orthopedic surgeons, registrars and interns. Therefore, we conducted a national survey to: (1) assess the prevalence of burnout syndrome among French pediatric orthopedic surgeons; (2) determine the risks and protective factors associated with this syndrome. HYPOTHESIS: The prevalence of burnout among French pediatric orthopedic surgeons is at least as high as in other medical and surgical specialties. MATERIALS AND METHODS: We conducted a nationwide survey during the months of June and July 2022 by distributing a digitized questionnaire by e-mail. The burnout syndrome was assessed by the MBI (Maslach Burnout Inventory) score. Demographic and professional practice data were also collected. RESULTS: Thirty-eight interns and 65 pediatric orthopedic registrars took part in the survey, i.e. a participation rate estimated at 65.5% and 44.4% respectively. Twenty-six percent (n=10) of interns and 13.9% (n=9) of registrars had MBI scores suggestive of moderate or severe burnout. Respectively 20.8% (n=9) and 9.2% (n=6) of interns and registrars reported suicidal thoughts in the past year. After statistical analysis, medical errors (OR: 3.4336; 95% CI: 1.7164-6.869; p<0.001) and suicidal ideation (OR: 2.3075; 95% CI: 1.0480-5.081; p=0.038) were associated with severe burnout. Having children (OR: 0.495; 95% CI: 0.2491-0.983; p=0.044) emerged as a protective factor. DISCUSSION: With a high participation rate, this study reveals a high burnout rate among French pediatric orthopedic interns and registrars, even if slightly lower than those found in other surgical specialties. Interns seem more exposed to this risk than their seniors. The consequences of burnout are diverse but can be significant. These results necessitate a vigilant approach to the occurrence of burnout among health professionals, and the appropriate management of it. LEVEL OF EVIDENCE: III; descriptive cross-sectional study without a control group.

Are French orthopedic and trauma surgeons affected by burnout? Results of a nationwide survey.

INTRODUCTION: Burnout is a pathology that can affect care-giving professionals. It associates emotional exhaustion (EE), depersonalization (DP) and impaired personal accomplishment (PA). Surgery entails great responsibility and frequently heavy workloads, incurring risk of burnout. Data, however, are not available for French orthopedic and trauma surgeons. We therefore conducted a prospective survey to 1) assess burnout prevalence in French orthopedic surgeons, and 2) investigate risk factors and protective factors. HYPOTHESIS: Burnout prevalence is at least as high in French orthopedic surgeons as in other medical and surgical specialties. MATERIALS AND METHODS: A nationwide survey was conducted in France between February and April 2017, using a digitized questionnaire sent out by e-mail. Burnout was assessed on the MBI (Maslach Burnout Inventory), and depressive symptoms on the GHQ-12 (General Health Questionnaire-12). Demographic and occupational data were also collected. RESULTS: Out of 1,900 surgeons contacted, 441 (23%) responded. Mean age was 50.2±10.1 years; 413 (93.7%) were male. Sixty one (14%) reported elevated EE, 100 (23%) elevated DP, and 82 (19%) impaired AP. One hundred and seventy two (39%) showed burnout symptomatology (e.g., pathologic score on one MBI scale), while 47 (10%) had pathologic scores on 2 or 3 scales, indicating severe burnout. One hundred and ninety three (43%) would not advise their children to take up orthopedic surgery. Thirty eight (8%) expressed suicidal ideation. Statistical analysis identified public-sector practice (OR=4.6; 95% CI: 2.1-10.7; p=0.0002) and pathologic GHQ-12 score (OR=6.3; 95% CI: 2.2-17.8; p=0.0006) as risk factors for burnout. Outside activity (OR=0.39; 95% CI: 0.1-0.9; p=0.0406) and male gender (OR=0.2; 95% CI: 0.05-0.7; p=0.0160) emerged as protective factors. DISCUSSION: Despite a response rate of only 23% (n=441/1,900), the present study sheds light on burnout rates in French orthopedic surgeons, with 39% burnout symptoms and 10% severe burnout. Burnout impacts personal and occupational life, with increased suicidal ideation and impaired quality of life. The present results confirm the importance of screening and treatment in care-providers. TYPE OF STUDY: Level IV, prospective descriptive transverse study without control group.

Burnout syndrome in orthopaedic and trauma surgery residents in France: A nationwide survey.

BACKGROUND: Burnout syndrome is one of the manifestations of distress in healthcare workers and is characterised by emotional exhaustion (EE), depersonalisation (DP), and a sense of low personal accomplishment (PA). The surgical residency is a period of intense training that imposes major challenges on future surgeons, who may therefore be at high risk for burnout syndrome. Nevertheless, no data on burnout syndrome in orthopaedic and trauma surgery (OTS) residents in France is available. Therefore we performed a prospective survey to: (1) evaluate the prevalence of burnout syndrome among OTS residents in France, (2) and to look for factors associated with a higher or lower risk of burnout syndrome in the survey respondents. HYPOTHESIS: Burnout syndrome is at least as prevalent among OTS residents in France as among residents in other medical and surgical specialities. MATERIAL AND METHODS: A nationwide prospective survey was conducted in France between February and April 2017 via a digital questionnaire sent by email. Burnout syndrome was evaluated using the Maslach Burnout Inventory (MBI) and symptoms of depression using the General Health Questionnaire (GHQ-12). Demographic data and information on relationships with partners and working modalities were collected. RESULTS: Of 480 OTS residents, 107 (22%) completed the questionnaire. Mean age was 27 years and 65% (n=70) were male. High EE was reported by 26% (n=28), high DP by 63% (n=68), and low PA by 33% (n=36) of respondents. The scores on two or all three of the MBI sub-scales were abnormal, indicating severe burnout syndrome, in 40% (n=43) of respondents. The GHQ-12 scores indicated symptoms of depression in 40% (n=43) of respondents. Furthermore, 61% (n=66) of respondents stated that they would not recommend OTS or any other area of medicine to their children as a career and 10% (n=11) reported suicidal ideation during the past year. The statistical analysis identified three risk factors for burnout syndrome: medical errors (odds ratio [OR], 8.8; 95% confidence interval [95%CI], 1.7-58.7; p=0.0121), symptoms of depression (OR, 19.3; 95%CI, 2.9-196.0; p=0.0048), and living single (OR, 4.7; 95%CI, 1.4-18.9; p=0.0173). DISCUSSION: Despite the 22% response rate, this study provides useful information on the prevalence of burnout syndrome among OTS residents in France, with severe burnout in 40% and suicidal ideation in 10%. These prevalences may be overestimations, however, as residents who felt under stress may have been more likely to respond to the survey. In published studies, burnout syndrome was associated with higher risks of medical error and suicidal behaviour. These data emphasise the importance of detecting and managing burnout syndrome in healthcare staff. LEVEL OF EVIDENCE IV: Prospective descriptive cross-sectional survey with no control group.

Treatment of distal radius fractures with locking plates: an update.

Internal fixation with volar locking plates has revolutionized the treatment of distal radius fractures. Manufacturers have introduced plate designs that closely follow the anatomy of the distal radius. However, use of volar plates has also led to the emergence of new types of complications. While the use of monoaxial or polyaxial locking screws and of minimally invasive techniques (arthroscopy, preservation of pronator quadratus) increases the cost of the surgical procedure, it results in a tangible benefit for patients, allowing them to move their wrist almost immediately after surgery and to quickly regain their autonomy. We reviewed the literature to analyze the level of proof.