Abstract:
OBJECTIVES:With value-based payment models on the horizon, this study was designed to examine the perceptions of value-based care among orthopaedic traumatologists and how they influence their practice. DESIGN:Systems-based survey study. SETTING:Orthopaedic Trauma Association (OTA) research surveys. PARTICIPANTS:OTA members. MAIN OUTCOME MEASURE:Thirty-eight-question surveys focusing on 5 areas related to value-based care: understanding value, assessing interest, barriers, perceptions around implementing value-based strategies, and policy. RESULTS:Of 1106 OTA members, 252 members responded for a response rate of 22.7%. Consideration around cost was not different between hospital, academic, and private practice settings (P = 0.47). Previous reported experience in finance increased the amount surgical decision-making was influenced by cost (P < 0.01), along with reported understanding of implant costs (P < 0.01). Over half of the respondents (59.4%) believed value-based payments are coming to orthopaedic trauma. The vast majority (88.5%) believed bundled payments would be unsuccessful or only partially successful. With respect to barriers, a third of respondents (34.7%) indicated accurate cost data prevented the implementation of programs that track and maximize value, another third (31.5%) attributed it to a limited ability to collect patient-reported outcomes, and the rest (33.8%) were split between lack of institutional interest and access to funding. CONCLUSION:Our study indicated the understanding of value in orthopaedic trauma is limited and practice integration is rare. Reported experience in finance was the only factor associated with increased consideration of value-based care in practice. Our results highlight the need for increased exposure and resources to changing health care policy, specifically for orthopaedic traumatologists. LEVEL OF EVIDENCE:Level V. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Gorman TL,S Albersheim M,Parikh HR,Flagstad IR,Okelana AB,Vang S,Johal H,Cunningham BPdoi
10.1097/BOT.0000000000001622subject
Has Abstractpub_date
2019-11-01 00:00:00pages
S21-S25eissn
0890-5339issn
1531-2291pii
00005131-201910007-00006journal_volume
33 Suppl 7pub_type
杂志文章abstract:OBJECTIVE:To review the outcome of patients with concurrent dorsal dislocations and fracture-dislocations of the second, third, fourth, and fifth carpometacarpal (CMC) joints treated with open reduction and internal fixation (ORIF). DESIGN:Retrospective review. SETTING:Level 1 trauma center. PATIENTS:Between 1991 an...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200111000-00003
更新日期:2001-11-01 00:00:00
abstract::In a 3-year prospective randomized trial, the prognostic value of osteoporosis in terms of predicting healing complications due to implant failures or loss of fracture reduction has been studied in 113 patients with inter-trochanteric hip fractures treated with either a sliding screwplate or Ender nailing. According t...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199310000-00006
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:The open reduction and internal fixation of radial shaft fractures and osteotomies with standard 3.5-mm plates can be complicated by tendon irritation, hardware prominence, and fracture through the screw holes. With the advent of locking plate technology, implant companies and some surgeons have recommended e...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f8bf9b
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:To investigate the clinical and functional outcome in an elderly population with acetabular fractures after low-energy trauma treated acutely with a total hip arthroplasty supported by a reinforcement ring (Burch-Schneider antiprotrusion cage) and autologous bone grafting of the acetabulum. SETTING:Universi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200303000-00007
更新日期:2003-03-01 00:00:00
abstract::Bone grafts are the second most common tissue transplanted in the United States, and they are an essential treatment tool in the field of acute and reconstructive traumatic orthopaedic surgery. Available in cancellous, cortical, or bone marrow aspirate form, autogenous bone graft is regarded as the gold standard in th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001420
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200208000-00008
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:To determine whether the cost of nonoperative treatment, including those who require delayed operative treatment, is less than those receiving initial operative management. METHODS:We identified 4 recent randomized controlled trials comparing operative and nonoperative treatment of displaced midshaft clavic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,评审
doi:10.1097/BOT.0000000000000225
更新日期:2015-04-01 00:00:00
abstract::We reviewed 13 cases of unstable cervical spine treated by stabilization with posterior Roy-Camille plates and fusion. The patients were treated between 1985-1988. Six patients had acute traumatic episodes, three patients had posttraumatic instabilities, one patient had laminectomy for cervical spondylotic myelopathy,...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198903010-00005
更新日期:1989-01-01 00:00:00
abstract::Aggressive treatment of the multiply injured patient often requires early fixation of many fractures, some of which may be open. Often, patients develop postoperative fevers requiring a thorough workup to rule out infection. Recently, indium-111 white blood cell (WBC) imaging has become a valuable adjunct in the diagn...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To report the results from functional bracing of isolated ulnar shaft fractures. DESIGN:Retrospective review. SETTING:Two university hospitals. PATIENTS:Isolated ulnar shaft fractures in 444 patients were stabilized in functional braces that permitted full range of motion of all joints. INTERVENTION:Prefa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199808000-00009
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of patients with posterolateral tibial plateau fractures after open reduction and internal fixation with a fibula osteotomy-free posterolateral approach. DESIGN:Retrospective chart and operation note review. SETTING:A medical college-affiliated tertiary hospital. MATERIALS AND METHO...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000047
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport with hexapod external fixator. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Thirty-eight patients with infected nonunions of the tibi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001005
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that oblique screws at the ends of a plate provide increased strength of fixation as compared to standard screw insertion. DESIGN:Biomechanical laboratory study in synthetic bone test medium. METHODS:Narrow 4.5-mm stainless steel low-contoured dynamic compression plates were anchored ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200410000-00006
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:New locked plate devices offer theoretical advantages for the treatment of supracondylar femur fractures associated with a total knee arthroplasty (TKA). These devices also can be inserted with relative ease by using minimally invasive techniques, provide a fixed angle construct, and improve fixation in osteo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200603000-00005
更新日期:2006-03-01 00:00:00
abstract:INTRODUCTION:External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose d...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000817
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:To compare radiographic and clinical outcomes of supination external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B2.1) treated with transsyndesmotic screw fixation with those treated with deltoid and posterior inferior tibiofibular ligament (PITFL) repair. DESIGN:Case se...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000318
更新日期:2015-05-01 00:00:00
abstract::Although Kirschner wires are useful implants in many situations, migration of the wire and irritation of the surrounding soft tissues are common complications. Seven steps are described herein, which result in a Kirschner wire that is bent 180° angle, providing a smooth anchor into bone. Use of this technique produces...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318290f818
更新日期:2013-11-01 00:00:00
abstract::Fractures and dislocations of the sternum may be associated with flexion-compression injuries of the thoracic spine. Sternal injuries most commonly occur at or near the sternomanubrial joint. We present a patient with a known thoracic spine fracture who developed a subsequent late-onset, symptomatic sternomanubrial di...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199509040-00014
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Acceptable amounts of malrotation after CRPP for pediatric supracondylar humerus fracture (SCHFx) have yet to be defined. This is an attempt to correlate radiographic parameters of a malrotated SCHFx with degrees of rotational malalignment to assist intraoperative assessment of reduction. METHODS:3D models ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001735
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To quantify intrapelvic surface symmetry in reference to a preshaped suprapectineal acetabular implant. METHODS:In this cross-sectional study, an anatomically preshaped acetabular fracture implant was fitted on 3D surface models of 516 pelvises from a preexisting bone database using a software tool for autom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001373
更新日期:2019-03-01 00:00:00
abstract::A modified freehand method using a cannulated drill bit for the insertion of distal locking screws for interlocking intramedullary nails is described. It should be useful to introduce surgeons to interlocking and to aid those who are not comfortable with the freehand method. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199306000-00009
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:To develop an accurate machine learning (ML) predictive model incorporating patient, fracture, and trauma characteristics to identify individual patients at risk of an (occult) PMF. METHODS:Databases of 2 studies including patients with TSFs from 2 Level 1 trauma centers were combined for analysis. Using te...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001663
更新日期:2020-03-01 00:00:00
abstract::Pediatric femoral shaft fractures present many challenging patient care decisions. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention is commonplace in virtually all older children. Treatment is determined primarily by patient age as modified by clinical factor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001016
更新日期:2017-11-01 00:00:00
abstract::Not all fractures heal well or rapidly in the adult skeleton, and basic scientists and clinicians continue to search for ways to make fractures heal more predictably. It is a fundamental tenet of orthopaedics that skeletal injury is followed by inflammation and that this inflammatory response is the first stage in a s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181f17b33
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:The incidence of osteoporotic proximal tibial fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000004
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the difference in quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative CT scans in displaced intra-articular calcaneal fractures (DIACFs). DESIGN:Retrospective SETTING:: Level 1 and Level 2 academic centers. PATIENTS:Consec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001971
更新日期:2020-09-18 00:00:00
abstract:OBJECTIVE:This study was designed to investigate the specific type and incidence of implant failure in patients with a proximal femur fracture treated with a proximal femoral nail antirotation. This device has a helical-shaped blade as a neck-head holding device, instead of the lag screw used in other intramedullary na...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31822c53c1
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:To radiographically demonstrate the upper sacral nerve root tunnel (USNRT) in both cadaveric specimens and a clinical cohort and to quantify its clinical relevance. SETTING:Level 1 trauma center and anatomy laboratory. PATIENTS AND PARTICIPANTS:Eleven cadaveric pelves and 23 consecutive patients who underw...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a2e419
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:This study was designed to investigate the relationship between upper extremity (UE) injuries and occupant restraint systems among front seat occupants who were involved in frontal motor vehicle collisions (MVCs). DESIGN:Case-control. SETTING:The 1995 through 2002 National Automotive Sampling System (NASS)...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000161543.52643.ab
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PAT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000840
更新日期:2017-07-01 00:00:00