Prevalence, Prevention, and Treatment of Work-Related Musculoskeletal Disorders Among Microsurgeons
Ruya Zhao1, Evan Rothchild1; Fei Wang1; David Nash1, Nicolas Greige1, Brittany Lala1, Joseph A. Ricci1
1Division of Plastic & Reconstructive Surgery, Montefiore Medical Center, Bronx, NY, USA
Background: Musculoskeletal disorders have been recognized as one of the most prevalent work-related injuries among surgeons, and microsurgeons are particularly susceptible to musculoskeletal injury due to long work hours, repetitive movements, static positions, and challenging instrument design. Our study aims to define the impact of musculoskeletal ailments on microsurgeons and investigate trends in microsurgeon musculoskeletal injury treatment.
Methods: An 18-question electronic survey was sent to all 883 listed members of the American Society of Reconstructive Microsurgery who met inclusion criteria. Each surgeon received a unique link that was deactivated after form submission to prevent duplicate responses. The questionnaire solicited surgeon demographics, microsurgical volume, equipment usage, history of musculoskeletal injury, impact of injury, and interventions used to address these issues. A self-reported utility score from 1-5 (5 (1 = least useful, 5 = most useful) was assigned for all interventions. Analysis was done via Chi-square test, Fisher's exact test, Analysis of Variance test, Wilcoxon rank sum test, and Kruskal-Wallis test.
Results: Of the 883 microsurgeons surveyed, 203 responded (23% response rate). The average age was 45 years (IQR 39-52 yrs). Most microsurgeons were male (80.8%). Musculoskeletal injury or symptoms related to microsurgery were reported by 137 respondents (67.0%). Fifty surgeons (37.9%) reported that their musculoskeletal injury had adversely affected their practice. Formal medical intervention was sought by 53 respondents (26.1%) and the most common medical interventions were visits with a specialist (19.2%), radiographic studies (16.8%), and physical therapy (16.8%). Seventeen surgeons (8.4%) underwent surgical intervention and surgery had the highest utility score (3.5/5). Self-treatment was used by 127 microsurgeons (62.6 %) for musculoskeletal ailments. Preventative treatments such as tretching, massage therapy, strength training, yoga, and dietary modifications were interventions with the highest utility scores (4/5).
Conclusion: The toll that performing microsurgery takes on the surgeon's musculoskeletal health is underappreciated. Most microsurgeons experience musculoskeletal injury, and some even require surgery to treat their musculoskeletal pathology. Prophylactic practices such as strength training, stretching, yoga, massages, and diet maintenance, are the superior treatment for musculoskeletal injury. Microsurgeons should incorporate training routines in their lives as injury prophylaxis to improve their career longevity and patient care.
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