How Many Referrals to a Pediatric Orthopaedic Hospital Specialty Clinic Are Primary Care Problems?
|
|
- Ambrose Townsend
- 5 years ago
- Views:
Transcription
1 ORIGINAL ARTICLE How Many Referrals to a Pediatric Orthopaedic Hospital Specialty Clinic Are Primary Care Problems? Eric Y. Hsu, MD,* Richard M. Schwend, MD,w and Leamon Julia, RNz Purpose: Many primary care physicians believe that there are too few pediatric orthopaedic specialists available to meet their patients needs. However, a recent survey by the Practice Management Committee of the Pediatric Orthopaedic Society of North America found that new referrals were often for cases that could have been managed by primary care practitioners. We wished to determine how many new referral cases seen by pediatric orthopaedic surgeons are in fact conditions that can be readily managed by a primary care physician should he/she chose to do so. Methods: We prospectively studied all new referrals to our hospital-based orthopaedic clinic during August Each new referral was evaluated for whether it met the American Board of Pediatrics criteria for being a condition that could be managed by a primary care pediatrician. Each referral was also evaluated for whether it met the American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to an orthopaedic specialist, regardless of whether it is for general orthopaedics or pediatric orthopaedics. On the basis of these criteria, we classified conditions as either a condition manageable by primary care physicians or a condition that should be referred to an orthopaedic surgeon or a pediatric orthopaedic surgeon. We used these guidelines not to identify diagnosis that primary care physicians should treat but, rather, to compare the guidelinedelineated referrals with the actual referrals our specialty pediatric orthopaedic clinic received over a period of 1 month. Results: A total of 529 new patient referrals were seen during August A total of 246 (47%) were considered primary care conditions and 283 (53%) orthopaedic specialty conditions. The most common primary care condition was a nondisplaced phalanx fracture (25/246, 10.1%) and the most common specialty condition was a displaced single-bone upper extremity fracture needing reduction (36/283, 13%). Only 77 (14.6%) of the total cases met the strict American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to pediatric orthopaedics, with scoliosis being the most frequent condition. From the *Department of General Surgery, University of Missouri Kansas City School of Medicine; wdepartment of Pediatric Orthopaedic Surgery, University of Missouri School of Medicine; and zdepartment of Orthopaedic Surgery, Children s Mercy Hospital, Kansas City, MO. This Research Project did not receive funding from organizations or other industry support. The authors declare no conflict of interest. Reprints: Richard M. Schwend, MD, Department of Orthopaedics, UMKC School of Medicine, Children s Mercy Hospital, 2401 Gillham Rd., Kansas City, MO rmschwend@cmh.edu. Copyright r 2012 by Lippincott Williams & Wilkins For 38 (7.2%) cases, surgical treatment was required or recommended. Patient age, referral source, or type of insurance did not influence whether the condition was a primary care or a specialty care case. A total of 134 (25%) cases were referred without having an initial diagnosis made by the referring clinician. These patients were more likely to have been referred from a primary care practitioner than from a tertiary care practitioner whether the diagnosis eventually made was considered to be a primary care condition (P = 0.03; relative risk, 1.9; 95% confidence interval, ). Conclusions: Almost half of all new referrals to a tertiary pediatric orthopaedic clinic were for conditions considered to be manageable by primary care physicians should they chose to do so. Significance: This has implications for pediatric orthopaedic workforce availability, reimbursement under the Affordable Care Act, and pediatric musculoskeletal training needs for providers of primary care. Key Words: referral patterns of pediatric orthopaedics, primary care orthopaedic problems, pediatric orthopaedic problems, referral source of pediatric orthopaedic problems (J Pediatr Orthop 2012;32: ) INTRODUCTION/BACKGROUND The American Academy of Pediatrics (AAP) guidelines have recommended that pediatric orthopaedic surgeons be referred cases such as malignant bone tumors, benign bone tumors, congenital deformities, limb malformations, metabolic bone disease, dysplasia of hips, bone and joint infections, slipped capital femoral epiphysis, scoliosis, complex fractures/dislocations, and other growth-related musculoskeletal conditions. 1 However, recent studies found that up to 95% of the new referrals to a pediatric orthopaedic surgeon were for common conditions or normal variants, with surgical treatment rates ranging from clinic patients range from 3% to 10%. 2 Although pediatric orthopaedic surgeons have traditionally been willing to see these patients, pediatricians also believe that pediatric orthopaedic surgeons are 1 specialty with a severe workforce shortage. 3 As a result, having a large number of referrals for these primary care types of conditions can lead to longer wait times and make it difficult for children with urgent and pediatric orthopaedic specialty problems to be seen. We felt that further study was needed to determine how many of the referred cases seen by pediatric J Pediatr Orthop Volume 32, Number 7, October/November
2 Hsu et al J Pediatr Orthop Volume 32, Number 7, October/November 2012 orthopaedic surgeons could be considered manageable by primary care physicians. The 2002 AAP guidelines only delineates diagnosis that should receive pediatric orthopaedic management but not conditions requiring general orthopaedic management, such as displaced fractures. We used it in conjunction with the American Board of Pediatrics (ABP) referral criteria, dividing the patient population into 2 groups: those conditions manageable by primary care physicians and those requiring either general orthopaedic or pediatric orthopaedic management. We defined these primary care cases by excluding those cases not meeting our combined criteria of AAP referral guidelines and the current ABP Review Committee s criteria. We hope that these data can help determine how many cases managed by pediatric orthopaedic specialists are primary care problems, develop improved pediatric orthopaedic referral criteria, and perhaps assist in future workforce projections and training needs of pediatric primary care clinicians. METHODS All new patients presenting to Children s Mercy Hospital Orthopaedic Clinic during August 2010 were studied. The Children s Mercy Hospital, located in Kansas City, Missouri, has numerous pediatric subspecialty clinics, 241 inpatient beds and nearly 400 pediatric specialists. It is the only level 1 pediatric trauma center in the region. The hospital receives referrals from Missouri, Kansas, Iowa, Nebraska, Oklahoma, Arkansas, and beyond. Patient age, sex, insurance, referral source, previsit diagnosis, postvisit diagnosis, and treatment were prospectively abstracted from the medical record. Patients who were admitted through the emergency room but did not get seen in the orthopaedic clinic, inpatient consults not seen in the clinic, or patients who were already established in our practice were excluded from this analysis. To define a pediatric specialty care problem, the AAP guideline for referral to a pediatric orthopaedic specialist, from the AAP Surgical Advisory Panel (SAP) guidelines for referral to pediatric surgical subspecialists, was used. 1 This included malignant bone tumors, benign bone tumors, congenital deformities of the upper extremity, limb malformations, metabolic bone disease, dysplasia of hips, bone/joint infections, slipped capital femoral epiphysis, scoliosis, complex fractures/dislocations, and growth arrest. However, other conditions not listed under these AAP guidelines problems may still be considered specialty care. A specialty care condition that did not meet the specific AAP referral guidelines may be a condition needing referral to an orthopaedic surgeon but not necessarily one specialized in pediatric orthopaedics. We divided the patient groups according to our combined ABP and SAP criteria, to study how many referrals were made to orthopaedic surgeons, both pediatric and general. As our institution is a children s hospital, all of the referral cases were seen by pediatric orthopaedic surgeons. The combined criteria details are those referrals that requires a specialists management, for example long cast application of upper or lower extremity, treatment of displaced fractures, scaphoid fracture, intra-articular fractures, open fractures, compartment syndrome, nerve or vascular injury, and injuries, lesions, or developmental anomalies. Specialists care includes both general orthopaedic surgeons and pediatric orthopaedic surgeons. These referrals are grouped together under the same category of referrals that should be managed by a specialist. The ABP 2010 certification criteria and competency 4 was used to define a primary care condition. A condition was considered a primary care problem if it was not included in the list of specific AAP SAP criteria or was not included by our combined criteria for orthopaedic referral. Primary care conditions included buckle fractures, sprains, nondisplaced fractures not requiring reduction or long casts, finger fractures treated with buddy taping or splinting only, nondisplaced toe fractures, fractures that received only a sling for comfort, developmental anomalies or variations that needed only counseling and observation without surgery, and simple injuries or laceration. In general, a primary care condition is a problem that could be managed by a provider with basic musculoskeletal education and experience and not requiring advanced diagnostic evaluation, complex reduction, or surgical treatment. Data were compiled to determine the number of cases that met AAP referral criteria for specialty care, combined criteria with ABP for specialty care, and criteria for being a primary care condition. Further analysis evaluated referral pattern differences in age, location, insurance status, and whether the patient presented with an established diagnosis. RESULTS During August 2010, a total of 529 new patients were seen in the Children s Mercy Hospital outpatient orthopaedic clinic. Of these, 246 patients (47%) were considered to have a primary care condition and 283 (53%) a specialty care condition. A total of 38 patients (7.2%) were scheduled for surgical treatment. Of the total 529 new cases, 77 (14.6%) met the specific AAP SAP criteria recommending specialty pediatric orthopaedic surgery referral (Table 1). Scoliosis was the most common problem (35/77, 45.5%), followed by a bone lesion (11/77, 14%), spine anomaly (7/77, 9.1%), developmental dysplasia of the hip (7/77, 9.1%) and syndactyly (3/77, 3.8%). A total of 283 (53%) patients with a new specialty care condition were seen using our combined criteria (Table 2). The most common specialty care condition was a displaced upper extremity single-bone fracture (36/283, 13%), followed by both-bone displaced fracture (31/283, 11%), scoliosis (31/283, 11%), lower extremity fracture requiring a long-leg cast (24/283, 8.5%), and significant knee injury with 3 of them requiring surgery (20/283, 7.1%). There were 246 (47%) new cases that were considered to be a primary care condition, but nevertheless were still seen in the pediatric orthopaedic clinic (Table 3). The r 2012 Lippincott Williams & Wilkins
3 J Pediatr Orthop Volume 32, Number 7, October/November 2012 Pediatric Orthopaedic Primary Care Problems TABLE 1. Conditions That Should Be Referred to Pediatric Orthopaedics (AAP Surgery Advisory Panel Recommendations) Specialty Problem N Percent of 77 Scoliosis Bone lesion Spine anomaly, spondylolysis Developmental dysplasia of hip Syndactyly Other Total Other problems, 1 each (1.2%): achondroplasia, synostosis, lumbar gibbus, Kabuki syndrome, slipped capital femoral epiphysis, 1q36 deletion syndrome, Noonan syndrome, McCune-Albright syndrome, Splengel deformity, Scheuermann disease, Perthes disease, spondylocostal dysostosis, and Van Der Wonde, San Filippo, Hurler, Ehler Danlos syndromes. AAP indicates American Academy of Pediatrics. 5 most common primary care problems were nondisplaced, nonangulated phalanx fracture treated with a splint or buddy taping (25/246, 10.1%), femoral anteversion (24/246, 9.8%), nondisplaced single-bone fracture of the upper extremity (22/246, 8.9%), normal examination (17/246, 6.9%), and radius buckle fracture receiving a short splint or cast (13/246, 5.3%). There were 38 (7.2% of total) new patients who received surgical treatment (Table 4). The 2 most common surgical cases were osteochondral lesion excision and angulated phalanx fracture management, 4 patients each, 10.5% of the total 38 surgical cases. Other surgical conditions included release of trigger thumb (3/38, 7.9%), treatment for adolescent idiopathic scoliosis (2/38, 5.3%), developmental dysplasia of hip (2/38, 5.3%), single-bone upper extremity fracture (2/38, 5.3%), both-bone upper extremity fracture (2/38, 5.3%), foreign body (2/38, 5.3%), and bone cyst excision (2/38, 5.3%). Of the 246 total primary care conditions, 229 (93%) were referrals from primary care physicians/facilities and the remaining 17 (7%) were from tertiary care physicians/ facilities. Of the 283 total specialty care conditions, 254 (90%) were referrals from primary care physicians/facilities and 29 (10%) were from specialty care physicians/ facilities. There were no differences in referrals patterns for problems that we considered to be primary care versus specialty care, based on patient age, whether the referral came from within or from outside our institution, whether the referral came from the emergency room, and whether the family was on Medicaid. Of the 529 total cases, 134 (25% of all cases) arrived without a diagnosis. Of these 134 cases without diagnosis, 68 (50.7%) were from primary care providers and 66 (49.3%) were from specialty care. These 134 cases were further divided into whether they were considered by us to be a primary care condition or a specialty condition. If a patient was seen without an initial diagnosis and later determined to have a primary care condition, then the patient was more likely to come from a primary care referral source (P = 0.03; relative risk, 1.9; 95% confidence interval, ). TABLE 2. Specialty Care Problems: Conditions That Should Be Referred to Orthopaedics (Either Pediatric Orthopaedics or General Orthopaedics) Percent of Problem N 283 Displaced upper extremity single-bone fracture Both-bone displaced fracture Scoliosis Lower extremity fracture requiring long-leg cast Knee injury Bone lesion requiring surgery Spasticity of lower extremity Deformity requiring surgery (upper and lower) Cyst removal, surgical Developmental dysplasia of hip Phalanx fracture, displaced Displaced metacarpal fracture Spine anomaly/vertebral fracture/spondylosis/ spondylothesis Clubfoot Trigger thumbs Spondylolisthesis Avulsion, displaced Foreign body requiring surgical excision Toddler fracture of tibia requiring long-leg cast Tibial triplane injury Syndactyly Arthrogryposis Metaphyseal fracture Left wrist fracture Cavovarus, severe Leg length discrepancy Tight heel cord Scaphoid fracture Other Total Other problem, 1 each (0.4%): metatarsal fracture, achondroplasia, avascular necrosis, hallux valgus requiring surgery, synostosis, pseudoarthrosis, equinous contracture, fibrous subtalar coalition, lumbar gibbus, Kabuki syndrome, slipped capital femoral epiphysis, severe metatarsal adductus requiring surgery, monteggia fracture, muscle contracture requiring surgery, 1q36 deletion syndrome, Noonan, cortical irregularity, osteopenia, mandible fracture, McCune-Albright syndrome, Splengel deformity, crush injury/displaced/angulated requiring surgery, Scheuermann disease, Perthes disease, spondylocostal dysostosis, shoulder dislocation, tillaux fracture, torticollis, degenerative joint disease/trochlear dysplasia/idiopathic erosion, right cervical rib, and Van Der Wonde, San Filippo, Hurler, Ehler Danlos syndromes. DISCUSSION A recent survey by the Practice Management Committee of the Pediatric Orthopaedic Society of North America found that up to 95% of the new referrals to an orthopaedic surgeon were for common conditions or normal variants. Relatively few (3%) of these referrals resulted in surgical treatment. With a perceived shortage of the pediatric orthopaedic specialists, longer waiting times for more urgent cases are common, whereas a large number of patients with primary care problems also wanting to be seen. 3 We wished to determine how many of the referral cases seen by pediatric orthopaedic surgeons are really primary care conditions, defined using all cases exclusive of AAP specialty referral guidelines, our combined criteria and the ABP Review Committee s criteria for a pediatric general practitioner s competency. r 2012 Lippincott Williams & Wilkins 729
4 Hsu et al J Pediatr Orthop Volume 32, Number 7, October/November 2012 TABLE 3. Conditions That Can Be Readily Managed by Primary Care Physicians Problem N Percent of 246 Phalanx fracture Femoral anteversion Single-bone fracture upper extremity Normal examination Radius buckle fracture Metatarsal fracture Minor knee injury Sprain Tibia torsion Planovalgus foot Humerus fracture Bow legs Both-bone fracture forearm, nondisplaced Tibia fracture Simple laceration injury Ankle fracture Clavicle fracture Deformity, minimal function inhibition Hip flexor Crush injury Idiopathic pain Chronic back pain Contusion Metacarpal fracture Postural kyphosis Avulsion fracture Benign cyst Metatarsus adductus Cervical spine injury Curly toe Other Total Remaining problems, 1 each (0.4%): axial distance increase, mild bunion, capillary malformation, fascia hernia, fight bite, foreign body of foot, idiopathic lesion requiring no management, wound care, mild shoulder instability, corner fracture, rotator cuff strain, granuloma annulare, Osgood-Schlatter, Sinding- Larson-Johansson syndromes, enthesopathy. During the August 2010, all new patients seen in the Children s Mercy Hospital Orthopaedic Clinic were prospectively evaluated. We chose the month of August as representative of our practice, because historically there is a heavy load of trauma, school physical referrals, sports referrals, and the usual new referrals. Specific AAP SAP guidelines for referral in conjunction with our own criteria were used to define a specialty care condition. We wanted as broad a definition of specialty condition, either a condition that should be seen by a pediatric orthopaedic surgeon or one that could be seen by a general orthopaedist. We used the ABP 2010 certification criteria and competency, as well as all cases that did not meet our definition of a specialty care condition, to define a primary care condition. Essentially, a primary care condition was considered a condition that a reasonably trained general physician or practitioner would be able to manage should they chose to do so. Only 77 cases of 529 new cases (14.6%) met the specific AAP SAP criteria for needing pediatric orthopaedic surgery referral. The 5 most common conditions that required involvement of a pediatric orthopaedic TABLE 4. Patients Receiving Surgical Treatment Percent Total Problem N of 38 Osteochondral lesion excision Angulated phalanx fracture Trigger thumb Adolescent idiopathic scoliosis Developmental dysplasia of hip/chronic left hip dislocation Single-bone upper extremity fracture Both-bone upper extremity fracture Foreign body Bone cyst excision Other Total Other problems, 1 each (2.6%): polysyndactyly release, nonhealing wound excision, patella instability, idiopathic sclerotic growth excision, bone grafting, slipped capital femoral epiphysis pinning, percutaneous pinning procedures, meniscus tear/repair, right thumb duplication excision, synostosis, heel-cord contracture release, spastic quadriplegia/elbow/wrist contracture release, bone infection excision, right tibia displacement from triplane fracture fixation, Van Der Woude syndrome. specialist were scoliosis, bone lesion, spine anomaly, developmental dysplasia of hip, and syndactyly. Although only 77 cases were considered to need management by a pediatric orthopaedic specialist, all of the other cases were not necessarily primary care, as specific AAP SAP criteria still allowed many cases to be managed by a general orthopaedic surgeon. A primary care provider should recognize the need for referral to orthopaedics, either to a general orthopaedic surgeon or for specific conditions, to a pediatric orthopaedic surgeon, whenever one of these conditions is encountered. A larger number of cases (283, 53%) were considered specialty care by our combined criteria. To be considered a specialty care condition, a patient must either has met AAP SAP referral criteria, received surgery, had a long cast applied, or had a displaced fracture needing reduction. The most common specialty condition was a displaced upper extremity single-bone fracture, followed by a both-bone forearm fracture, scoliosis, lower extremity fracture, or knee injury requiring surgery. Any traumatic injury requiring surgery or a long cast application, closed reductions under sedation, other surgical procedures, or situations that primary providers are often uncomfortable with were all classified as specialty care. There were 246 (47%) new cases that we considered to be a primary care condition. This study was similar to Hennrikus et al 5 recent study in that close to 50% of all new patient referrals to an orthopaedic specialist clinic were determined to be a primary care condition. In our study, simple nondisplaced fractures that may be readily managed by a primary care physician were classified as a primary care condition. Application of a simple splint, short-arm cast, and buddy taping of nondisplaced finger injuries are examples of problems manageable by primary care clinicians. The most common primary care condition was a nondisplaced finger fracture that could have been managed without the need for specialist referral. Simple r 2012 Lippincott Williams & Wilkins
5 J Pediatr Orthop Volume 32, Number 7, October/November 2012 Pediatric Orthopaedic Primary Care Problems stable fractures that were nondisplaced and did not require long casts were considered manageable by a primary care physician, a saving of both time and resources. A total of 38 patients of the total 529 received surgery (7.2%, 1 of 14 new patients). This is a much smaller percent receiving surgery than seen in other studies of new adult orthopaedic patients. In recent studies by McCarthy et al, <3% to 10% of all pediatric orthopaedic referrals resulted in surgery. 2 The study from the POSNA Practice Management Committee found that pediatric orthopaedic surgeons saw 13 patients per scheduled surgery, whereas adult orthopaedic surgeons saw 2.7, general surgery 4.1, and neurosurgery 3.2 patients per surgery scheduled. 2 These ratios indicate that pediatric orthopaedic surgeons are seeing a large percentage of primary care problems that do not require more specialized surgical management. Despite pediatric orthopaedic surgeons willingness to treat these primary care conditions, many of these problems could be cared for by primary care providers if they had adequate education and incentives. Reeder et al 6 recommended better education in musculoskeletal diagnosis and treatment of simple musculoskeletal conditions such as nondisplaced fractures. There were no significance differences in referral patterns among the demographic characteristics of patient age, visit source, and insurance status. However, when a patient was seen without an initial diagnosis and was later determined to have a primary care condition, then she/he was more likely to have been referred from a primary care provider rather than from a specialty care source. This suggests that a specialist maybe more likely to refer the patient back to their primary care provider for these types of problems rather than to another specialist. This study has limitations. The geographic location of our study in a large midwest city may not be generalized for other metropolitan area of the United States or for rural locations. Although the study was prospective and captured all new referrals, it covered only 1 month, August New residents were working in the hospital, which may have affected primary care referral patterns. We do not have data on how many cases are already treated by a primary care physician, before 1 referral is made to an orthopaedic specialist; thus, we may be only seeing a small percentage of the referral problems. The noted difference in referral patterns between primary and specialty care providers, although clinically significant, has a confidence interval that crossed the number 1, thus making it of questionable statistical significance. The combined criteria for a primary care problem that we used were subjective and have not been validated as a basis for determining what is or is not a primary care condition. Larger, multicenter data collection and analysis would allow for more accurate and generalizable conclusions. Lastly, a primary care physician s comfort, knowledge base, and credentials should also be considered, as our study purpose was to demonstrate what are the problems that primary care physicians could readily care for, should they chose to do so. The Affordable Health Care Act 2010 may have several effects on the practice of pediatric orthopaedics. Because almost one half of the conditions seen in our ambulatory specialty setting are considered primary care conditions, pediatric orthopaedics may need consideration as a primary care specialty, as is the case for obstetrics and gynecology. This has implications for manpower decisions, training pediatric orthopaedic surgeons, hiring of advance practitioners, and equitable reimbursement for care delivered. If pediatric orthopaedic surgeons are considered as primarily tertiary care providers, then improvement and expansion of the musculoskeletal education and competencies of primary care providers is needed to care for these primary care conditions. In conclusion, this prospective study of all new referrals to a hospital-based pediatric orthopaedic specialty clinic found that 47% of the new referrals were for conditions we consider to be a primary care, manageable by a primary care physician. This has implications for pediatric orthopaedic workforce availability, reimbursement under the Affordable Care Act, and pediatric musculoskeletal training needs of primary care providers. REFERENCES 1. Surgical Advisory Panel. Guidelines for referral to pediatric surgical specialists. Pediatrics. 2002;110: McCarthy JJ, Armstrong DG, Davey JP, et al. The current medical practice of the pediatric orthopaedic surgeon in North America. J Pediatr Orthop. 2011;31: Schwend RM. The pediatric orthopaedics workforce demands, needs, and resources. J Pediatr Orthop. 2009;29: The American Board of Pediatrics. A guide to evaluating your clinical competence in pediatrics. Chapel Hill, NC: The American Board of Pediatrics; 2011:1 9. Available at 5. Hennrikus W, Kobilis J, Hamp J. Referral patterns to a pediatric orthopaedic clinic: pediatric orthopaedic surgeons are primary care musculoskeletal medicine physicians. Pediatrics [In press]. 6. Reeder BM, Lyne ED, Patel DR, et al. Referral patterns to a pediatric orthopaedic clinic: implications for education and practice. Pediatrics. 2004;113:e163 e167. r 2012 Lippincott Williams & Wilkins 731
Orthopedics. 1. GOAL: Understand the pediatrician's role in preventing and screening for
The University of Arizona Pediatric Residency Program Primary Goals for Rotation Orthopedics 1. GOAL: Understand the pediatrician's role in preventing and screening for orthopedic injury, disease and dysfunction.
More informationTopics and Cases in Pediatric Orthopaedics (Tuesday 6:30am 4 th Floor Orthopaedic Conference Room at Hamot)
2015-2016 Topics and Cases in Pediatric Orthopaedics (Tuesday 6:30am 4 th Floor Orthopaedic Conference Room at Hamot) 1. Considerations in the Management of Pediatric Patients Kerry Armet 7 July 2015 Fluid
More informationPediatric Orthopedics in Your Office. Laurel Saliman, MD Pediatric Orthopedic Surgeon Swedish Pediatric Specialty Care
Pediatric Orthopedics in Your Office Laurel Saliman, MD Pediatric Orthopedic Surgeon Swedish Pediatric Specialty Care Overview for 20 minute whirlwind Clavicle Distal radius fractures Finger fractures
More informationREFERRAL GUIDELINES: ORTHOPAEDIC SURGERY
All patients referred to specialist clinics are assigned to a priority category based on their clinical need and related psychosocial factors. The examples given are indicative only and the clinician reviewing
More informationSurgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE
Surgical Care at the District Hospital 1 18 Orthopedic Trauma Key Points 2 18.1 Upper Extremity Injuries Clavicle Fractures Diagnose fractures from the history and by physical examination Treat with a
More informationMusculoskeletal System
Musculoskeletal System CPT CPT copyright 2011 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the
More informationDART Diagnosis and Related Treatments
DART Diagnosis and Related Treatments The DART Tool allows a user to obtain Treatment recommendations based on the disorder/condition. These recommendations are provided by ACOEM (American College of Occupational
More informationUniversity of South Florida
University of South Florida Pediatric Orthopaedics PGY 4 Competency Based Goals & Objectives Competency 1- Patient Care: Provide family centered patient care that is developmentally and age appropriate,
More informationDEPARTMENT OF PEDIATRICS WALTER REED NATIONAL MILITARY MEDICAL CENTER NATIONAL CAPITAL CONSORTIUM PEDIATRIC RESIDENCY PROGRAM.
DEPARTMENT OF PEDIATRICS WALTER REED NATIONAL MILITARY MEDICAL CENTER NATIONAL CAPITAL CONSORTIUM PEDIATRIC RESIDENCY PROGRAM February 2016 PEDIATRIC ORTHOPEDIC AND SPORTS MEDICINE ROTATION 1. DURATION:
More informationORTHOPEDICS AND TRAUMATOLOGY TRAINING PROGRAM
ORTHOPEDICS AND TRAUMATOLOGY TRAINING PROGRAM (3 Weeks) YEDİTEPE UNIVERSITY HOSPITAL Head of the Department of Orthopedics and Traumatology: Faik Altıntaş, MD Prof. Uğur Şaylı, MD Prof. Turhan Özler, MD
More informationAdult Reconstruction Hip Education Tracks
Adult Reconstruction Hip Education Tracks Adult Reconstruction Hip Track for the Specialist - HIP1 ICL 281 A Case-based Approach to High Risk Total Hip - When Do I Do Something Differently? ICL 241 The
More informationPEDIATRIC CASTING AND SPLINTING HEATHER KONG, M.D. SHRINERS HOSPITAL FOR CHILDREN PORTLAND OCTOBER 7, 2017
PEDIATRIC CASTING AND SPLINTING HEATHER KONG, M.D. SHRINERS HOSPITAL FOR CHILDREN PORTLAND OCTOBER 7, 2017 DISCLOSURES I have no financial relationship with any company or product discussed in this presentation.
More informationFoot and Ankle Natalie Stork, MD
Foot and Ankle Natalie Stork, MD Assistant Professor University of Missouri-Kansas City School of Medicine, Department of Orthopaedic Surgery and Department of Pediatrics Children s Mercy Kansas City,
More informationMontreal Children s Hospital McGill University Health Center Emergency Department Fracture Guideline
Montreal Children s Hospital McGill University Health Center Emergency Department Guideline Disclaimers This document is designed to assist physicians working in our emergency department in caring for
More informationIn-toeing and Out-toeing
In-toeing and Out-toeing What is all the fuss about? Natalie Stork, MD Assistant Professor University of Missouri-Kansas City School of Medicine, Department of Orthopaedic Surgery and Department of Pediatrics
More informationWEEKLY CLINICAL SCHEDULES. Martin Boyer (hand surgery) Monday Tuesday Wednesday Thursday Friday AM PM AM PM AM PM AM PM AM PM Academic
WEEKLY CLINICAL SCHEDULES Martin Boyer (hand surgery) Academic AM OC OC day CAM CAM PM with Dr. Lindley Wall Carpal tunnel syndrome PIP dislocation CMC arthritis Cubital Tunnel Syndrome Distal Radius Fracture
More informationApply this knowledge into proper management strategies and referrals
1 2 3 Lower Extremity Injuries Jason Kennedy, M.D. Disclosures I have no financial/ industry disclosures. Objectives Identify common lower extremity injury patterns in the child and adolescent Apply this
More informationGENERAL ORTHOPAEDIC PROGRAM SCHEDULE 18. January 25 26, 2019 Rosemont, IL. Albert J. Aboulafia, MD & Isador H. Lieberman, MD, MBA, FRCSC
AAOS Board Maintenance of Certification Preparation and Review GENERAL ORTHOPAEDIC PROGRAM SCHEDULE 18 CME Credits January 25 26, 2019 Rosemont, IL Albert J. Aboulafia, MD & Isador H. Lieberman, MD, MBA,
More informationYour Orthotics service is changing
Your Orthotics service is changing Important for referrers on changes effective from January 2015 Why is the service changing? As demand for the orthotics service increases and budgets remain relatively
More information1. Discuss some common pediatric problems seen in the clinic. Diagnosis Clinical examination (at birth and subsequent well-baby examinations)
1 Pediatric Orthopaedics for Primary Care Providers 2 Disclosure Statement No conflicts related to this presentation 3 4 Goals 1. Discuss some common pediatric problems seen in the clinic 2. Examination
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Abductor hallucis tendon procedures, for hallux varus, 536 537 Acetabular disorders, intoeing in, 551 553 Akron dome osteotomy, for cavus deformities,
More informationMusculoskeletal Referral Guidelines
Musculoskeletal Referral Guidelines Introduction These guidelines have been developed to provide an integrated musculoskeletal service. They are based on reasonable clinical practice and will initially
More informationCommon Orthopaedic Injuries in Children
Common Orthopaedic Injuries in Children Rakesh P. Mashru, M.D. Division of Orthopaedic Trauma Cooper University Hospital Cooper Medical School of Rowan University December 1, 2017 1 Learning Objectives
More informationANTERIOR MEDIAL AND POSTERIOR MEDIAL DEFORMITY OF THE TIBIA
ANTERIOR MEDIAL AND POSTERIOR MEDIAL DEFORMITY OF THE TIBIA 5 TH ANNUAL SLAOTI MEETING SAO PAOLO, BRAZIL OCTOBER 12-14, 2017 Richard M Schwend MD Professor Orthopaedics and Pediatrics Director of Research
More informationBasic Care of Common Fractures Utku Kandemir, MD
Basic Care of Common Fractures Utku Kandemir, MD Assistant Clinical Professor Trauma & Sports Medicine Dept. of Orthopaedic Surgery UCSF / SFGH History Physical Exam Radiology Treatment History Acute trauma
More informationUG CURRICULUM FOR ORTHOPAEDICS UNIVERSITY OF DELHI
UG CURRICULUM FOR ORTHOPAEDICS UNIVERSITY OF DELHI OBJECTIVES OF THE COURSE: At the end of the program, student should acquire the following: 1. Diagnose the common musculo-skeletal disease process from
More information1. Review specialty services and programs available through Shriners Hospitals for Children
Outreach Clinics: Creating Accessibility to Specialty Healthcare for Rural Families Presented By: Erin Jurkovich Director of Professional Relations Shriners Hospitals for Children Twin Cities June 15,
More informationTrauma & Orthopaedic Undergraduate Syllabus
Trauma & Orthopaedic Undergraduate Syllabus Introduction The purpose of this document is to provide a recommended syllabus for medical students in Trauma & Orthopaedics (T&0). It should help students on
More informationPediatric Fractures. Objectives. Epiphyseal Complex. Anatomy and Physiology. Ligaments. Bony matrix
1 Pediatric Fractures Nicholas White, MD Assistant Professor of Pediatrics Eastern Virginia Medical School Attending, Pediatric Emergency Department Children s Hospital of The King s Daughters Objectives
More informationICD-10 CM Training. Orthopaedic
ICD-10 CM Training Orthopaedic ICD-10-CM Compliance Dates ICD-10-CM will be valid for dates of service on or after October 1, 2015 Outpatient dates of service of October 1, 2015 and beyond. Inpatient hospital
More informationCLINICAL CONCEPTS FOR ORTHOPEDICS. CMS Clinical Concepts
CLINICAL CONCEPTS FOR ORTHOPEDICS CMS Clinical Concepts ICD 10 LESSONS FROM OFFICE DOCUMENTATION Presented by Dr. Frankeny OUR CHALLENGE: CHANGING OUR DOCUMENTATION ICD 10 Learn the nomenclature Documenting
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Abscess, epidural, 822 824 Achilles tendon rupture, 894 895, 981 982 Acromioclavicular separations, shoulder pain in, 751 753 Adhesive capsulitis,
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Achilles tendonitis, criteria for full competition in, 164 165 description of, 164 patient education in, 165 prophylactic support in,
More informationSERVICES. Contact us. Rapid Assessment, Intervention and Treatment
Contact us For more information about Orthopaedic Services, please visit our website at www.londonbridgehospital.com or contact: GP Liaison Department Tel: +44 (0)20 7234 2009 Fax: +44 (0)20 7234 2019
More informationWEEKLY CLINICAL SCHEDULES. Martin Boyer (hand surgery) Monday Tuesday Wednesday Thursday Friday AM PM AM PM AM PM AM PM AM PM VA OR Wohl
WEEKLY CLINICAL SCHEDULES Martin Boyer (hand surgery) VA OR Wohl Dr. Goldfarb CAM OC OC OR CAM CAM OR Carpal tunnel syndrome PIP dislocation CMC arthritis Cubital Tunnel Syndrome Distal Radius Fracture
More informationPediatric Orthopaedic Fellowship Curriculum
Pediatric Orthopaedic Fellowship Curriculum The Fellowship Pediatric Orthopaedic Curriculum is designed for the fellow to spend three months each in four content areas. There are five content areas comprising
More informationPhase II Health Sciences as Applied to Coaching.
Phase II Health Sciences as Applied to Coaching www.topform.us Overview What is going to be covered today is.. Skeletal System Muscular System Most common injuries to know about in your sport Part One:
More informationGoals. Initial management skeletal trauma. Physical Exam ABC OF PRIMARY CARE MEDICINE FRACTURE MANAGEMENT 12/4/2010
ABC OF PRIMARY CARE MEDICINE FRACTURE MANAGEMENT Brian Feeley, MD UCSF Sports Medicine and Shoulder Surgery Goals Discuss common fractures and initial management, treatment guidelines Let your patients
More informationPage 1 of 6. Appendix 1
Page 1 Appendix 1 Rotation Objectives and Schedule 1. Introductory Month 4 weeks 2. Total Joints 4 weeks a. Diagnosis and management of hip and knee arthritis b. Indications for surgery c. Implant selection;
More information4. Counsel patients and families regarding athletic participation, including:
Sports Medicine Primary Goals for this Rotation GOAL: Prevention, Counseling and Screening. Understand the pediatrician's role in preventing sports-related injuries, disorders and dysfunction in children
More information40 th Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure
40 th Annual Symposium on Sports Medicine Travis Murray, MD Assistant Professor University of Texas Health Science Center San Antonio Knee Injuries In The Pediatric Athlete Disclosure Dr. Travis Murray
More informationPRESENTED BY: JOHN STIMLER, DO, CPC, CHC, FACEP BSA HEALTHCARE AND BSA HEALTHCARE ADVISORY GROUP
PRESENTED BY: JOHN STIMLER, DO, CPC, CHC, FACEP BSA HEALTHCARE AND BSA HEALTHCARE ADVISORY GROUP TOPICS (1) Fracture types ICD-10-CM diagnostic coding CPT procedure coding Fracture care treatments: Manipulated
More informationA. Clinical Studies Group: Orthopaedic Surgery
A. Clinical Studies Group: Orthopaedic Surgery Chair: Professor Damian Griffin Disease/disorder covered: Orthopaedic Surgery This research strategy maps out the direction for orthopaedic clinical research.
More informationPEM GUIDE CHILDHOOD FRACTURES
PEM GUIDE CHILDHOOD FRACTURES INTRODUCTION Skeletal injuries account for 10-15% of all injuries in children; 20% of those are fractures, 3 out of 4 fractures affect the physis or growth plate. Always consider
More informationPractice Changes I Hope You Make
Is that Bad? What PCPs (& Parents) Need to Know about Fractures Aharon Z. Gladstein, MD Pediatric Orthopaedics & Sports Medicine Texas Children s Hospital Assistant Professor, Orthopaedics Baylor College
More informationOther Congenital and Developmental Diseases of the Foot. Department of Orthopedic Surgery St. Vincent s s Hospital, The Catholic University
Other Congenital and Developmental Diseases of the Foot Department of Orthopedic Surgery St. Vincent s s Hospital, The Catholic University Contents Metatarsus Adductus Skewfoot Hallux Valgus Hallux Valgus
More informationLower Extremity Disorders in Children and Adolescents Brian G. Smith. DOI: /pir
Lower Extremity Disorders in Children and Adolescents Brian G. Smith Pediatrics in Review 2009;30;287 DOI: 10.1542/pir.30-8-287 The online version of this article, along with updated information and services,
More informationCOURSE OUTLINE-IB 128: SPORTS MEDICINE INTRODUCTION
COURSE OUTLINE-IB 128: SPORTS MEDICINE INTRODUCTION Definition of sports medicine Pre-participation physical exam Epidemiology of sports injuries injury rates for various sports sports risks relative to
More informationSports Medicine in your office: What not to miss!
Sports Medicine in your office: What not to miss! 2018 Primary Care Approach to Treating the Injured Athlete May 4, 2018 John H. Wilckens, MD Associate Professor, Dept of Orthopaedic Surgery Disclosures
More informationPhyseal Fractures and Growth Arrest
Physeal Fractures and Growth Arrest Raymond W. Liu, M.D. Victor M. Goldberg Master Clinician-Scientist in Orthopaedics Rainbow Babies and Children s Hospital Case Western Reserve University Outline General
More informationRegions Hospital Delineation of Privileges Orthopaedic Surgery
Regions Hospital Delineation of Orthopaedic Surgery Applicant s Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting. Review education and basic formal
More information1 Chapter 29 Orthopaedic Injuries Principles of Splinting 2 Types of Muscles. Striated Skeletal. Smooth
1 Chapter 29 Orthopaedic Injuries Principles of Splinting 2 Types of Muscles Striated Skeletal Smooth 3 Anatomy and Physiology of the Musculoskeletal System 4 Skeletal System 5 Skeletal System Functions
More informationORTHOPEDIC/SPORTS MEDICINE ROTATION SYLLABUS
ORTHOPEDIC/SPORTS MEDICINE ROTATION SYLLABUS Level of Training PGY 2 or PGY 3 Length of Rotation 8 weeks Preceptors /Attendings Name(s) and Titles Edward Forster, MD, (FMC faculty contact) Tallahassee
More informationChapter 29 Orthopaedic Injuries Principles of Splinting Types of Muscles
1 2 3 4 5 6 7 Chapter 29 Orthopaedic Injuries Principles of Splinting Types of Muscles Striated Skeletal Smooth Anatomy and Physiology of the Musculoskeletal System Skeletal System Skeletal System Functions
More informationAAOS Board Maintenance. Preparation and Review: General Orthopaedic. of Certification. OLC Education & Conference Center. January 25 26, 2019
AAOS Board Maintenance of Certification Preparation and Review: General Orthopaedic January 25 26, 2019 OLC Education & Conference Center Rosemont, IL Albert J. Aboulafia, MD Isador H. Lieberman, MD, MBA,
More informationAO SEC Course on Nonoperative Fracture Treatment. June 17 19, 2010 University Teaching Hospital, Lusaka/Zambia
AO SEC Course on Nonoperative Fracture Treatment June 17 19, 2010 University Teaching Hospital, Lusaka/Zambia 2 AO Foundation Socio Economic Committee AO Foundation Socio Economic Committee 3 A word of
More informationTHEORY LECTURE CURRICULUM OF M.B.B.S 2015 BATCH Modified on Friday
THEORY LECTURE CURRICULUM OF M.B.B.S 2015 BATCH Modified on Friday Topic No of Lecture Faculty 1- INTRODUCTION OF ORTHOPAEDICS 2 Dr. Puneet Gupta (A) Definition (B) Various terminologies (C) Orthopaedic
More information& & 392 & C1-C2
Abbreviations...424 Abdominal Aortic Aneur... 302 Abdominal Rapid DDx...401 AC Sprain... 140 Acetabular Labral Tear... 222 Achilles Tendinopathy... 286 ACL Sprain/Tear... 236 Advanced Wobble Board... 395
More informationTHE Salter-Harris classification is a radiologic
Advanced Emergency Nursing Journal Vol. 29, No. 1, pp. 10 19 Copyright c 2007 Wolters Kluwer Health Lippincott Williams & Wilkins Radiology R O U N D S Column Editor: Jonathan Lee Salter-Harris Fractures
More informationThe Child With a Limp
KID WITH A LIMP Common in ED, common in Exams Differential diagnosis is very wide Most causes benign, but mustn't miss Septic arthritis Osteomyelitis Fractures / NAI SUFE (older, heavier children) The
More informationRunning Injuries in Children and Adolescents
Running Injuries in Children and Adolescents Cook Children s SPORTS Symposium July 2, 2014 Running Injuries Overuse injuries Acute injuries Anatomic conditions 1 Overuse Injuries Pain that cannot be tied
More informationBrasington/Diemer/Boyer (rheumatology, bone health, hand) Monday Tuesday Wednesday Thursday Friday AM PM AM PM AM PM AM PM AM PM 8 a.m.
WEEKLY CLINICAL SCHEDULES Martin Boyer (hand surgery) Academic day CAM CAM 1 AM PM with Dr. Lindley Wall OC Carpal tunnel syndrome PIP dislocation CMC arthritis Cubital Tunnel Syndrome Distal Radius Fracture
More informationWE MUSCULOSKELETAL SYSTEM. ORTHOPAEDICS
WE MUSCULOSKELETAL SYSTEM. ORTHOPAEDICS For all paediatric orthopaedics see WS430 1 Societies 11 History 13 Dictionaries. Encyclopaedias. Bibliographies Use for general works only. Classify with specific
More informationIndex. Clin Podiatr Med Surg 23 (2006) Note: Page numbers of article titles are in boldface type.
Clin Podiatr Med Surg 23 (2006) 233 239 Index Note: Page numbers of article titles are in boldface type. A Acclimatization, in sports preconditioning program, 197 Achilles tendon lengthening of, for equinus
More informationEpidemiology 7/11/2016. Common Fractures and Musculoskeletal Injuries on the Field. Overuse Injuries. Sprains(ligaments) and Strains(muscles)
Common Fractures and Musculoskeletal Injuries on the Field Jason Kennedy,M.D. Department of Orthopedics Cook Children s Medical Center Fort Worth, Texas Overuse Injuries Sprains(ligaments) and Strains(muscles)
More informationContents SECTION 1: GENERAL TRAUMA AND RECONSTRUCTIVE HIP SURGERY
SECTION 1: GENERAL TRAUMA AND RECONSTRUCTIVE HIP SURGERY 1. Acetabular and Pelvic Fractures...3 2. Acetabular Orientation (Total Hips)...6 3. Acetabular Osteotomy...7 4. Achilles Tendon Ruptures...9 5.
More informationNE Nebraska Trauma Conference Tristan Hartzell, MD November 8, 2017
NE Nebraska Trauma Conference 2017 Tristan Hartzell, MD November 8, 2017 Traumatic arm injuries in the elderly Fractures Hand Wrist Elbow Shoulder Soft tissue injuries Definitions Elderly? old or aging
More informationYour Orthotics service is changing
Your Orthotics service is changing Important information for service users on changes effective from July 2015 Why is the service changing? As demand for the Orthotics service increases, Livewell Southwest
More information- within 16 weeks. Semi-urgent - within 8 weeks
National Access Criteria for First Specialist Assessment Category Definitions: These are recommended guidelines for HHS specialists prioritizing referrals from primary care Immediate - within 1 week Urgent
More informationFOOSH It sounded like a fun thing at the time!
FOOSH It sounded like a fun thing at the time! Evaluating acute hand and wrist injuries Larry Collins, MPAS, PA-C, ATC, DFAAPA Assistant Professor, Physician Assistant Program Assistant Professor, Department
More informationSalisbury Foundation Trust Radiology Department Referral Guidelines for Primary Care: Musculoskeletal Imaging
Salisbury Foundation Trust Radiology Department Referral Guidelines for Primary Care: Musculoskeletal Imaging These guidelines have been issued in conjunction with the Royal College of Radiology referral
More informationChiropractic ICD-10 Common Codes List
Chiropractic ICD-10 Common Codes List This is a preliminary list of Common ICD-10 Codes for chiropractic diagnoses. This is a common code list to be used as a guide for coding and is not intended to represent
More informationTrauma-related Pediatric Orthopedic Emergencies. Javier Gonzalez del Rey, M.D. Professor Pediatrics Cincinnati Children s Hospital Medical Center
Trauma-related Pediatric Orthopedic Emergencies Javier Gonzalez del Rey, M.D. Professor Pediatrics Cincinnati Children s Hospital Medical Center Room # 10 7 month old sick since birth Room # 11 5 y/o Fell
More informationPEDIATRIC AND CONGENITAL IMAGING GUIDELINES MUSCULOSKELETAL 2009 MedSolutions, Inc
MedSolutions, Inc. This tool addresses common symptoms and symptom complexes. Imaging requests for patients with atypical Clinical Decision Support Tool symptoms or clinical presentations that are not
More informationSETTING THE STAGE FOR SERVICE PLANNING: A profile of arthritis and bone and joint conditions NORTH EAST LHIN
ARTHRITIS COMMUNITY RESEARCH & EVALUATION UNIT (ACREU) University Health Network SETTING THE STAGE FOR SERVICE PLANNING: A profile of arthritis and bone and joint conditions NORTH EAST LHIN *Address for
More information42 nd Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure
42 nd Annual Symposium on Sports Medicine Travis Murray, MD Assistant Professor University of Texas Health Science Center San Antonio January 23, 2015 Knee Injuries In The Pediatric Athlete Disclosure
More informationFOOSH It sounded like a fun thing at the time!
FOOSH It sounded like a fun thing at the time! Evaluating acute hand and wrist injuries Larry Collins, MPAS, PA-C, ATC, DFAAPA Assistant Professor, Physician Assistant Program Assistant Professor, Department
More informationCluster - 26 ORTHOPEDICS. X Ray of Affected Limb, MIR of Shoulder
Sr.No Package no 1708 26.1 Orthopeidc 1709 26.2 Orthopeidc Sub speciality Procedure name Pre-Operative Investigation AC joint reconstruction/ Stabilization/ Acromionplasty (Nonoperative management is recommended
More informationABPS 500. Examination Blueprints (Revised Classification) American Board of Podiatric Surgery 445 Fillmore Street San Francisco, CA
ABPS 500 Examination Blueprints () American Board of Podiatric Surgery 445 Fillmore Street San Francisco, CA 94117-3404 (415) 553-7800 (415) 553-7801 (FAX) info@abps.org November 2012 Purpose, Test Specification,
More informationBCCH Emergency Department LOWER LIMB INJURIES Resource pack
1 BCCH Emergency Department LOWER LIMB INJURIES Resource pack Developed by: Rena Heathcote RN. 2 Knee Injuries The knee joint consists of a variety of structures including: 3 bones (excluding the patella)
More informationNursing Management: Musculoskeletal Trauma and Orthopedic Surgery. By: Aun Lauriz E. Macuja SAC_SN4
Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery By: Aun Lauriz E. Macuja SAC_SN4 The most common cause of musculoskeletal injuries is a traumatic event resulting in fracture, dislocation,
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Achilles tendinopathy in dancers, 831 832 treatment of PRP in, 871 872 Achilles tendinopathy/tendonitis in ultramarathon athletes, 847
More informationLoma Linda University Children s Hospital Loma Linda, CA ORTHOPAEDIC SURGERY PRIVILEGE FORM
Name: Page 1 of 6 REQUEST CATEGORY MEMBERSHIP CATEGORY Provisional (Bylaws 4.3) Administrative (Bylaws 4.7) Affiliate (Bylaws(4.9) Active (Bylaws 4.2) Courtesy (Bylaws 4.4) Consulting (Bylaws 4.5) All
More informationICD 10 Readiness analysis
Case Study ICD 10 Readiness analysis nirmal.raja@qbsshealth.com Introduction Physician documentation for ICD-10-CM will need to be more specific and detailed than is required for ICD-9- CM. The codes will
More informationPediatric Orthopedics: ``To Refer or Not to Refer``
Pediatric Orthopedics: ``To Refer or Not to Refer`` Thierry E. Benaroch, MD, FRCS(C) McGill University Health Centre Intoeing Knock knees Bowlegs Flatfeet Toe walking Knee pain Hip click Intoeing Objectives
More informationDEPARTMENT OF ORTHOPEDICS UG Teaching Schedule. (October 2016 February 2017)
DEPARTMENT OF ORTHOPEDICS UG Teaching Schedule (October 2016 February 2017) THEORY (3 PM 4 PM) 07.10.2016 CTEV and flat foot 14.10.2016 CDH 21.10.2016 Torticollis, congenital pseudoarthrosis of tibia and
More informationLongitudinal Sports Medicine Experience Family Medicine Faculty Liaison: Peter Lundblad, MD, FAAFP, CAQSM Last review/update: 2/2017
Longitudinal Sports Medicine Experience Family Medicine Faculty Liaison: Peter Lundblad, MD, FAAFP, CAQSM The Sports Medicine experience includes a required 1-week block experience completed in the 1 st
More informationUTILIZING CPT AND HCPCS CODES FOR HEALTHCARE REIMBURSEMENT: A guide to billing and reimbursement of SpiderTech kinesiology tape products
UTILIZING CPT AND HCPCS CODES FOR HEALTHCARE REIMBURSEMENT: A guide to billing and reimbursement of SpiderTech kinesiology tape products Billing and coding of taping and strapping services can be a complex
More informationAAOS Board Maintenance of Certification Preparation and Review
AAOS Board Maintenance of Certification Preparation and Review November 2 4, 2017» Boston, MA Guarantee to Pass* General Review November 2 4 Albert J. Aboulafia, MD and O. Alton Barron, MD Foot & Ankle
More informationPEDIATRIC ORTHOPAEDIC SURGERY THE SPECTRUM
PEDIATRIC ORTHOPAEDIC SURGERY THE SPECTRUM A child's musculoskeletal problems are different from those of an adult. As children are still growing, the body's response to injuries, infections, and deformities
More informationSETTING THE STAGE FOR SERVICE PLANNING: A profile of arthritis and bone and joint conditions ERIE ST. CLAIR LHIN
ARTHRITIS COMMUNITY RESEARCH & EVALUATION UNIT (ACREU) University Health Network SETTING THE STAGE FOR SERVICE PLANNING: A profile of arthritis and bone and joint conditions ERIE ST. CLAIR *Address for
More informationWill She Still Make the WNBA? Sports Injuries & Fractures
Will She Still Make the WNBA? Sports Injuries & Fractures Aharon Z. Gladstein MD Pediatric Orthopaedic Surgery Pediatric Sports Medicine Sports Injuries Chronic (overuse) Acute Who can be treated in PCP
More informationContents. copyrighted material by PRO-ED, Inc. Chapter 1. Chapter 2. Chapter 3. Chapter 4. Chapter 5. Conditions in Athletic Injuries
Acknowledgments xiii Introduction to the First Edition xv Introduction to the Second Edition xvii Chapter 1 Conditions in Athletic Injuries Anterior Cruciate Ligament (ACL) Tear 2 Biceps Tendon Strain
More informationCASE ONE CASE ONE. RADIAL HEAD FRACTURE Mason Classification. RADIAL HEAD FRACTURE Mechanism of Injury. RADIAL HEAD FRACTURE Imaging
CASE ONE An eighteen year old female falls during a basketball game, striking her elbow on the court. She presents to your office that day with a painful, swollen elbow that she is unable to flex or extend
More informationAll new applicants must meet the following requirements as approved by the UNM SRMC Board of Directors effective: 03/21/ 2012
[ ] Initial appointment [ ] Reappointment Instructions All new applicants must meet the following requirements as approved by the UNM SRMC Board of Directors effective: 03/21/ 2012 Applicant: Check off
More informationPost test for O&P 2 Hrs CE. The Exam
Post test for O&P 2 Hrs CE The Exam This examination is taken in "open book" format. That means you are free to answer the questions after research or discussion with your fellow workers. We feel this
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Acetabular fractures, 462 464 Achilles tendon rupture, 389 Acromioclavicular dislocations, 302 Acromion fractures, 301 Ankle, anatomy of, 376
More informationMusculoskeletal and Orthopaedic Conditions Treated
General category Sub-categories Often used diagnosis/common terms Muscle and tendon pain and injuries Strains, tears/ruptures, contusions, lacerations, muscle pain, myofascial pain Tendinopathy, tendinitis,
More informationA Patient s Guide to Limping in Children
A Patient s Guide to Limping in Children 651 Old Country Road Plainview, NY 11803 Phone: 5166818822 Fax: 5166813332 p.lettieri@aol.com DISCLAIMER: The information in this booklet is compiled from a variety
More information