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Background: This study aimed to identify the most frequent reasons for orthopedic medical malpractice, gain insight into the related patient demographics and clinical characteristics, and identify the independent factors associated with it., Methods: We collected and analyzed the demographic and injury characteristics, hospital levels and treatments, medical errors, and orthopedist's degree of responsibility for the patients who were subject to orthopedic medical malpractice at our institution. Univariate and multivariate analyses were performed to identify the factors associated with the orthopedist's degree of responsibility in the medical malpractice cases., Results: We included 1922 cases of medical malpractice in the final analysis. There were 1195 and 727 men and women, respectively (62.2% and 37.8%, respectively). Of the total patients, 1810, 1038, 1558, 1441, and 414 patients (94.2%, 54.0%, 81.1%, 75.0%, and 21.5%, respectively) were inpatients, had closed injuries, underwent surgery, were trauma cases, and had preoperative comorbidities, respectively. Most medical malpractice cases were in patients with fractures and spinal degenerative disease (1229 and 253 cases; 63.9% and 13.2%, respectively), and occurred in city-level hospitals (1006 cases, 52.3%), which were located in the eastern part of china (1001, 52.1%), including Jiangsu and Zhejiang (279 and 233 cases, 14.52% and 52.1%, respectively). Between 2016 and 2017, the orthopedist's degree of responsibility in medical malpractice claims were deemed as full, primary, equal, secondary, and minor in 135, 654, 77, 716, and 340 orthopedists (7.0%, 34.0%, 4.0%, 37.3%, and 17.7%). Most medical errors made by orthopedists in cases of medical malpractice were related to failure to supervise or monitor cases, improper performance of procedures, and failure to instruct or communicate with the patient (736, 716, and 423 cases; 38.3%, 37.3%, and 22.0%, respectively). The multivariate analysis found that patients with preoperative comorbidities, who sustained humerus injuries, who were aged ≥65 years, who were treated by doctors who failed to supervise or monitor them, and who were treated at the provincial and city level hospitals were more likely to claim that the orthopedist bore a serious degree of responsibility in the medical malpractice case., Conclusions: Our results provide detailed information on the plaintiff demographics, clinical characteristics, and factors associated with medical malpractice. Medical malpractice is related to poor treatment outcomes. The first preventative measure that is required is a comprehensive improvement in the medical staff quality, mainly through medical ethics cultivation, and professional ability and technique training. Additionally, failure to supervise or monitor cases was the leading cause of medical malpractice and one of the factors that led to orthopedists bearing an equal and higher responsibility for medical malpractice. Orthopedists should improve patient supervision, especially when treating older patients and those with preoperative comorbidities and humerus injuries., Competing Interests: The authors have declared that no competing interests exist.

Background: Coronavirus disease 2019 (COVID-19) broke out in Wuhan, the People's Republic of China, in December 2019 and now is a pandemic all around the world. Some orthopaedic surgeons in Wuhan were infected with COVID-19., Methods: We conducted a survey to identify the orthopaedic surgeons who were infected with COVID-19 in Wuhan. A self-administered questionnaire was distributed to collect information such as social demographic variables, clinical manifestations, exposure history, awareness of the outbreak, infection control training provided by hospitals, and individual protection practices. To further explore the possible risk factors at the individual level, a 1:2 matched case-control study was conducted., Results: A total of 26 orthopaedic surgeons from 8 hospitals in Wuhan were identified as having COVID-19. The incidence in each hospital varied from 1.5% to 20.7%. The onset of symptoms was from January 13 to February 5, 2020, and peaked on January 23, 8 days prior to the peak of the public epidemic. The suspected sites of exposure were general wards (79.2%), public places at the hospital (20.8%), operating rooms (12.5%), the intensive care unit (4.2%), and the outpatient clinic (4.2%). There was transmission from these doctors to others in 25% of cases, including to family members (20.8%), to colleagues (4.2%), to patients (4.2%), and to friends (4.2%). Participation in real-time training on prevention measures was found to have a protective effect against COVID-19 (odds ratio [OR], 0.12). Not wearing an N95 respirator was found to be a risk factor (OR, 5.20 [95% confidence interval (CI), 1.09 to 25.00]). Wearing respirators or masks all of the time was found to be protective (OR, 0.15). Severe fatigue was found to be a risk factor (OR, 4 [95% CI, 1 to 16]) for infection with COVID-19., Conclusions: Orthopaedic surgeons are at risk during the COVID-19 pandemic. Common places of work could be contaminated. Orthopaedic surgeons have to be more vigilant and take more precautions to avoid infection with COVID-19., Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Aim: To conduct a scientometric assessment of the research activities of spinal fusion in various subspecialties carried out by different surgeons., Material and Methods: All articles regarding spinal fusion research on Web of Science from the year 1994 to 2015 were identified and analyzed in the following aspects: year of publication, publication journal, number of times cited, Hirsch index (H-index), spine surgeon specialty, and country/territory., Results: A total of 15060 articles were identified, and the research productivity of spinal fusion has grown steadily over the last two decades. The average research productivity of spinal fusion each year was 109.09 ± 23.26 articles for cervical spine, 90.09 ± 52.56 articles for thoracic spine, and 304.91 ± 181.63 articles for lumbar. The research productivity of spinal fusion by neurosurgeons was 9474 articles published, while the orthopedic surgeons published 8263 articles. The average number of citations for spinal fusion articles was 19.61 times for neurosurgeons, and 20.36 times for orthopedic surgeons. In most countries neurosurgoens published more spinal fusion articles than orthopedic surgeons or at least the same amount, but orthopedic surgeons in China and Germany published far more spinal fusion articles ( > 100) than neurosurgeons. The United States published the greatest number of articles (6819/15060, 45.28%), followed by China (1280/15060, 8.50%) and Germany (1252/15060, 8.31%), and had the highest total citations (164378) and H-index (144)., Conclusion: Neurosurgeons tend to publish more articles regarding spinal fusion, but orthopedic surgeons seem to have higher citations. North America, West Europe and East Asia were the most productive regions in spinal fusion research, and the United States made the most academic contributions to this area.