Abstract：
BACKGROUND: Previous studies have demonstrated a positive correlation between case volume and outcomes in foot and ankle surgery. This study elucidates surgical case volume benchmarks for Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic foot and ankle fellowship training in the United States.
METHODS: The ACGME provided case logs for orthopaedic residents and foot and ankle fellows (2018-2021). Variabilities in reported fellowship case volumes were defined as the fold-difference between 90th and 10th percentiles. Reported case volumes were compared between training cohorts with parametric tests.
RESULTS: Case logs from 65 orthopaedic foot and ankle fellows and 3146 orthopaedic residents were included. Fellows reported 1.3- to 1.5-fold more foot and ankle cases during fellowship training than during residency training (P < .001). On average, orthopaedic foot and ankle fellows reported 405.4 cases and most were arthrodesis (17%), forefoot reconstruction (17%), mid/hindfoot reconstruction (13%), tendon repair/transfer (12%), and trauma ankle hindfoot (11%). Case categories with the highest variabilities were amputation (14.8-fold difference), infection/tumor (11.6-fold difference), arthroscopy (9.2-fold difference), and calcaneus (8.7-fold difference).
CONCLUSIONS: Case volume benchmarks can assist trainees and faculty during orthopaedic foot and ankle training. More research is needed to determine case minimum requirements needed for autonomous practice in foot and ankle surgery.
UNASSIGNED: Level III.
METHODS: The ACGME provided case logs for orthopaedic residents and foot and ankle fellows (2018-2021). Variabilities in reported fellowship case volumes were defined as the fold-difference between 90th and 10th percentiles. Reported case volumes were compared between training cohorts with parametric tests.
RESULTS: Case logs from 65 orthopaedic foot and ankle fellows and 3146 orthopaedic residents were included. Fellows reported 1.3- to 1.5-fold more foot and ankle cases during fellowship training than during residency training (P < .001). On average, orthopaedic foot and ankle fellows reported 405.4 cases and most were arthrodesis (17%), forefoot reconstruction (17%), mid/hindfoot reconstruction (13%), tendon repair/transfer (12%), and trauma ankle hindfoot (11%). Case categories with the highest variabilities were amputation (14.8-fold difference), infection/tumor (11.6-fold difference), arthroscopy (9.2-fold difference), and calcaneus (8.7-fold difference).
CONCLUSIONS: Case volume benchmarks can assist trainees and faculty during orthopaedic foot and ankle training. More research is needed to determine case minimum requirements needed for autonomous practice in foot and ankle surgery.
UNASSIGNED: Level III.
摘要：
背景：先前的研究表明，病例体积与足踝手术的结果呈正相关。这项研究阐明了美国研究生医学教育认证委员会（ACGME）认可的骨科足踝研究金培训的手术病例量基准。
方法：ACGME为骨科居民和足踝研究员（2018-2021年）提供了病例日志。报告的研究金病例量的差异被定义为第90个百分位数和第10个百分位数之间的倍数差异。通过参数检验比较了训练队列之间报告的病例量。
结果：纳入了65名骨科足踝研究员和3146名骨科住院医师的病例记录。研究员报告的足踝病例在研究金培训期间比住院医师培训期间多1.3至1.5倍（P<.001）。平均而言,矫形外科足踝研究员报告405.4例，大多数为关节固定术（17％），前足重建(17%)，中足/后足重建（13％），肌腱修复/转移（12%），和足后踝关节创伤（11%）。差异最大的病例类别是截肢（差异14.8倍），感染/肿瘤（11.6倍差异），关节镜（9.2倍差异），和跟骨（8.7倍差异）。
结论：病例体积基准可以在骨科足部和踝关节训练期间帮助学员和教职员工。需要更多的研究来确定足部和踝关节手术自主实践所需的病例最低要求。
■三级。
方法：ACGME为骨科居民和足踝研究员（2018-2021年）提供了病例日志。报告的研究金病例量的差异被定义为第90个百分位数和第10个百分位数之间的倍数差异。通过参数检验比较了训练队列之间报告的病例量。
结果：纳入了65名骨科足踝研究员和3146名骨科住院医师的病例记录。研究员报告的足踝病例在研究金培训期间比住院医师培训期间多1.3至1.5倍（P<.001）。平均而言,矫形外科足踝研究员报告405.4例，大多数为关节固定术（17％），前足重建(17%)，中足/后足重建（13％），肌腱修复/转移（12%），和足后踝关节创伤（11%）。差异最大的病例类别是截肢（差异14.8倍），感染/肿瘤（11.6倍差异），关节镜（9.2倍差异），和跟骨（8.7倍差异）。
结论：病例体积基准可以在骨科足部和踝关节训练期间帮助学员和教职员工。需要更多的研究来确定足部和踝关节手术自主实践所需的病例最低要求。
■三级。
