Jaimo Ahn

Are Away Rotations Critical for a Successful Match in Orthopaedic Surgery

Surveys have suggested one of the most important determinants of orthopaedic resident selection is completion of an orthopaedic clerkship at the program director’s institution. The purpose of this study was to further elucidate the significance of visiting externships on the resident selection process. We retrospectively reviewed data for all medical students applying for orthopaedic surgery residency from six medical schools between 2006 and 2008, for a total of 143 applicants. Univariate and multivariate regression analyses were used to compare students who matched successfully versus those who did not in terms of number of away rotations, United States Medical Licensing Examination® scores, class rank, and other objective factors. Of the 143 medical students, 19 did not match in orthopaedics (13.3%), whereas the remaining 124 matched. On multiple logistic regression analysis, whether a student did more than one home rotation, how many away rotations a student performed, and United States Medical Licensing Examination® Step 1 score were factors in the odds of match success. Orthopaedic surgery is one of the most competitive specialties in medicine; the away rotation remains an important factor in match success.

Fractures in Brief: Olecranon Fractures

Olecranon fractures are relatively common injuries, accounting for approximately 10% of upper extremity fractures in adults [26]. These fractures may result from a direct blow to the proximal ulna, or indirectly, via the forceful contraction of the triceps against resistance (typically, during a fall onto an outstretched hand). Less commonly, the olecranon may fracture when the elbow is hyperextended, as the bone is impacted against the olecranon fossa of the distal humerus. For unstable injuries, operative fixation typically is required. Even after recovery, loss of ROM is not uncommon. This article provides an overview of olecranon fractures in adults; therefore, discussion of olecranon fractures in skeletally immature patients is beyond the scope of this article.

In Brief: Fractures in Brief: Femoral Neck Fractures

Femoral neck fractures are low-energy injuries in the aged, associated with frequent falls, ill health, and osteoporosis, and less commonly, high-energy injuries in the young. Femoral neck fractures are serious injuries. Although the surgical treatment for these fractures is refined, poor outcomes are not uncommon: many of the elderly patients die within a year of injury, and many of those who survive do not regain their preinjury level of function [5].