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Occupational Injury Among Orthopaedic Surgeons
William T. Davis, BS1; Vasanth Sathiyakumar, BA1; A. Alex Jahangir, MD1; William T. Obremskey, MD, MPH1; Manish K. Sethi, MD1
1 The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN 37221. E-mail address for W.T. Davis: tyler.davis@vanderbilt.edu. E-mail address for V. Sathiyakumar: vasanth.sathiyakumar@vanderbilt.edu. E-mail address for A.A. Jahangir: alex.jahangir@vanderbilt.edu. E-mail address for W.T. Obremskey: william.obremskey@vanderbilt.edu. E-mail address for M.K. Sethi: manish.sethi@vanderbilt.edu
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Aug 07;95(15):e107 1-6. doi: 10.2106/JBJS.L.01427
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Orthopaedic surgery is a physically demanding profession that requires many hours per week in body positions known to contribute to musculoskeletal injury and pain. Injuries to surgeons can affect the delivery of care and impose costs on the health care system. The aim of this study was to determine the prevalence and types of injuries sustained at the workplace during the career of an orthopaedic surgeon as well as the impact of such injuries on practicing surgeons.


A survey was developed to assess occupational injury among orthopaedic surgeons. Electronic surveys were distributed via e-mail to all orthopaedic surgeons in Tennessee. Data were analyzed to determine statistical associations of demographic and workplace factors with the rate of injury.


One hundred and forty (28%) of 495 surveys were returned, with representation from all orthopaedic subspecialties. Sixty-one (44%) of the respondents reported sustaining one or more injuries at the workplace during their career. A significant association was found between years performing surgery and prevalence of injury (p = 0.03), with surgeons working between twenty-one and thirty years reporting the most injuries. Twenty-five percent of respondents reported sustaining an injury to the hand; 19%, to the lower back; 10%, to the neck; 7%, to the shoulder; and 6%, to another area. Fourteen (10%) of all surgeons reported missing work as a result of a workplace injury, with five (4%) missing at least three weeks. Twenty-three surgeons (38% of injured respondents) reported that no institutional resources were available to support their recovery from the injury.


Our study is the first of its kind, to our knowledge, to demonstrate that many orthopaedic surgeons sustain occupational injuries during their careers. The volume of work missed suggests that occupational injury has economic implications for the health-care system and providers. Given the number of injured respondents reporting no institutional support for occupational injuries, more attention should be focused on this issue.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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    David RIng, MD PhD
    Posted on August 28, 2013
    Take care with the word injury
    Chief of Hand Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA

    The word injury implies damage needing repair. How many of the occupational "injuries" were normal aspects of human development such as enthesopathy or arthritis? For instance, current best evidence is that rotator cuff tears are more analogous to bald spots (attritional thinning) than traumatic defects. How many were vague illness constructs such as "overuse injuries"?  Human illness behavior is complex, and imprecise use of the word "injury" can decrease health and wellness.

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