Faculty Bibliography

Background/UNASSIGNED:Surgical volunteer organizations have been severely limited during the ongoing coronavirus disease pandemic. Our purpose was to identify obstacles to surgical volunteer organizations secondary to COVID-19 and their responses. Methods/UNASSIGNED:= 24). Univariate analyses were used to compare the two cohorts. Results/UNASSIGNED:= 0.02). The three leading obstacles were finances/donations (78%), fewer volunteers (38%), and inadequate personal protective equipment (30%). In response, 39% of surgical volunteer organizations developed novel E-volunteering opportunities. For support, 85% of surgical volunteer organizations suggested monetary donations, 78% promotion through social media platforms, and 54% donation of personal protective equipment. Conclusion/UNASSIGNED:The majority of surgical volunteer organizations were unable to maintain full functionality due to stressors caused by COVID-19, including limitations on finances, volunteers, and personal protective equipment.

Background/Purpose: Compartment syndrome is a well-known surgical emergency within the scope of Podiatry. However, cases can be atraumatic and present without the traditional findings of pain, pallor, paresthesia, pulselessness, paralysis, and poikilothermia. Thus, posing a diagnostic dilemma for clinicians, leading to delayed surgical intervention and poor outcomes. We report a rare case of acute exertional compartment syndrome and include a discussion on current literature to increase awareness of atypical presentations of compartment syndrome. Methods/Results: A 27-year-old healthy female with no significant past medical history was treated for intractable right foot pain following an extended period of marching. Physical examination was remarkable for non-palpable pedal pulses, pain out of proportion, extensive soft tissue edema, and a warm-to-cold temperature gradient of the extremity. The diagnosis of compartment syndrome was confirmed via catheter evaluation of compartmental pressures. Emergent fasciotomy of the right foot was performed, and delayed primary closure was performed six days later. After discharge from the hospital, the patient was inconsistent in follow up visits. Later repeat imaging of the right foot revealed stress fractures and nondisplaced fractures throughout the tarsometatarsal region. At her most recent visit, the patient complained of persistent paresthesias, skin discoloration, and pain to the right foot for which she is receiving symptomatic management for.
Conclusion(s): Diagnosis in this patient was likely delayed due to strict adherence to a post-traumatic model of compartment syndrome. Broadening awareness to the variable presentations of compartment syndrome is an important step to improve patient outcomes.
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»:The United States has faced substantial increases in health-care expenditure, with specifically large increases in spine surgery costs. »:Many different formulas are utilized to determine value in spine surgery, including cost- benefit analyses, cost-effectiveness analyses, and cost-utility analyses, with the overall determination of value being quality/cost. »:Quality often is calculated indirectly using either process measures or outcome measures and represents the potential benefit of a given intervention, usually over a specific time period to yield quality-adjusted life years. »:Costs are particularly difficult to calculate given the interhospital, regional, national, and global variability, as well as indirect costs of an intervention, and many different methods are utilized to estimate costs. »:Spine surgeons should be familiar with the elements that compose cost-effectiveness and their potential shortcomings in order for providers and health-care policy makers to identify the highest-quality studies and interventions that provide the greatest benefit to patients.