Tobias Gehlen

Background and Objective: The rapid development of artificial intelligence (AI) is impacting the medical sector by offering new possibilities for faster and more accurate diagnoses. Symptom checker apps show potential for supporting patient decision-making in this regard. Whether the AI-based decision-making of symptom checker apps shows better performance in diagnostic accuracy and urgency assessment compared to physicians remains unclear. Therefore, this study aimed to investigate the performance of existing symptom checker apps in orthopedic and traumatology cases compared to physicians in the field. Methods: 30 fictitious case vignettes of common conditions in trauma surgery and orthopedics were retrospectively examined by four orthopedic and traumatology specialists and four different symptom checker apps for diagnostic accuracy and the recommended urgency of measures. Based on the estimation provided by the doctors and the individual symptom checker apps, the percentage of correct diagnoses and appropriate assessments of treatment urgency was calculated in mean and standard deviation [SD] in [%]. Data were analyzed statistically for accuracy and correlation between the apps and physicians using a nonparametric Spearman’s correlation test (p < 0.05). Results: The physicians provided the correct diagnosis in 84.4 ± 18.4% of cases (range: 53.3 to 96.7%), and the symptom checker apps in 35.8 ± 1.0% of cases (range: 26.7 to 54.2%). The agreement in the accuracy of the diagnoses varied from low to high (Physicians vs. Physicians: Spearman’s ρ: 0.143 to 0.538; Physicians vs. Apps: Spearman’s ρ: 0.007 to 0.358) depending on the different physicians and apps. In relation to the whole population, the physicians correctly assessed the urgency level in 70.0 ± 4.7% (range: 66.7 to 73.3%) and the apps in 20.6 ± 5.6% (range: 10.8 to 37.5%) of cases. The agreement on the accuracy of estimating urgency levels was moderate to high between and within physicians and individual apps. Conclusions: AI-based symptom checker apps for diagnosis in orthopedics and traumatology do not yet provide a more accurate analysis regarding diagnosis and urgency evaluation than physicians. However, there is a broad variation in the accuracy between different digital tools. Altogether, this field of AI application shows excellent potential and should be further examined in future studies.

Background: Social media (SM) has been recognized as a professional communication tool in the field of orthopedic and trauma surgery that can enhance communication with patients and peers, and increase the visibility of research and offered services. The specific purposes of professional SM use and the benefits and concerns among orthopedic and trauma surgeons, however, remain unexplored. Objective: This study aims to demonstrate the specific uses of different SM platforms among orthopedic and trauma surgeons in Germany as well as the advantages and concerns. Methods: A web-based questionnaire was developed on the use of SM in a professional context by considering the current literature and the authors’ topics of interest. The final questionnaire consisted of 33 questions and was distributed among German orthopedic and trauma surgeons via the mail distributor of the Berufsverband für Orthopädie und Unfallchirurgie (Professional Association of Orthopaedic Surgeons in Germany). The study was conducted between June and July 2022. A subgroup analysis was performed for sex (male vs female), age (<60 years vs ≥60 years), and type of workplace (practice vs hospital). Results: A total of 208 participants answered the questionnaire (male: n=166, 79.8%; younger than 60 years: n=146, 70.2%). In total, all of the participants stated that they use SM for professional purposes. In contrast, the stated specific uses of SM were low. Overall, the most used platforms were employment-oriented SM, messenger apps, and Facebook. Instagram emerged as a popular choice among female participants and participants working in hospital settings. The highest specific use of SM was for professional networking, followed by receiving and sharing health-related information. The lowest specific use was for education and the acquisition of patients. Conventional websites occupied a dominating position, exceeding the use of SM across all specific uses. The key benefit of SM was professional networking. Under 50% of the participants stated that SM could be used to enhance communication with their patients, keep up-to-date, or increase their professional visibility. In total, 65.5% (112/171) of participants stated that SM use was time-consuming, 43.9% (76/173) stated that they lacked application knowledge, and 45.1% (78/173) stated that they did not know what content to post. Additionally, 52.9% (91/172) mentioned medicolegal concerns. Conclusions: Overall, SM did not seem to be used actively in the professional context among orthopedic and trauma surgeons in Germany. The stated advantages were low, while the stated concerns were high. Adequate education and information material are needed to elucidate the possible professional applications of SM and to address legal concerns.

BACKGROUND Social media (SM) has been recognized as a professional communication tool in the field of orthopedic and trauma surgery that can enhance communication with patients and peers, and increase the visibility of research and offered services. The specific purposes of professional SM use and the benefits and concerns among orthopedic and trauma surgeons, however, remain unexplored. OBJECTIVE This study aims to demonstrate the specific uses of different SM platforms among orthopedic and trauma surgeons in Germany as well as the advantages and concerns. METHODS A web-based questionnaire was developed on the use of SM in a professional context by considering the current literature and the authors’ topics of interest. The final questionnaire consisted of 33 questions and was distributed among German orthopedic and trauma surgeons via the mail distributor of the Berufsverband für Orthopädie und Unfallchirurgie (Professional Association of Orthopaedic Surgeons in Germany). The study was conducted between June and July 2022. A subgroup analysis was performed for sex (male vs female), age (<60 years vs ≥60 years), and type of workplace (practice vs hospital). RESULTS A total of 208 participants answered the questionnaire (male: n=166, 79.8%; younger than 60 years: n=146, 70.2%). In total, all of the participants stated that they use SM for professional purposes. In contrast, the stated specific uses of SM were low. Overall, the most used platforms were employment-oriented SM, messenger apps, and Facebook. Instagram emerged as a popular choice among female participants and participants working in hospital settings. The highest specific use of SM was for professional networking, followed by receiving and sharing health-related information. The lowest specific use was for education and the acquisition of patients. Conventional websites occupied a dominating position, exceeding the use of SM across all specific uses. The key benefit of SM was professional networking. Under 50% of the participants stated that SM could be used to enhance communication with their patients, keep up-to-date, or increase their professional visibility. In total, 65.5% (112/171) of participants stated that SM use was time-consuming, 43.9% (76/173) stated that they lacked application knowledge, and 45.1% (78/173) stated that they did not know what content to post. Additionally, 52.9% (91/172) mentioned medicolegal concerns. CONCLUSIONS Overall, SM did not seem to be used actively in the professional context among orthopedic and trauma surgeons in Germany. The stated advantages were low, while the stated concerns were high. Adequate education and information material are needed to elucidate the possible professional applications of SM and to address legal concerns.

Background: Social media (SM) has gained importance in the health care sector as a means of communication and a source of information for physicians and patients. However, the scope of professional SM use by orthopedic and trauma surgeons remains largely unknown. Objective: This study presents an overview of professional SM use among orthopedic and trauma surgeons in Germany in terms of the platforms used, frequency of use, and SM content management. Methods: We developed a web-based questionnaire with 33 variables and 2 separate sections based on a review of current literature. This study analyzed the first section of the questionnaire and included questions on demographics, type of SM used, frequency of use, and SM content management. Statistical analysis was performed using SPSS (version 26.0). Subgroup analysis was performed for sex, age groups (<60 years vs ≥60 years), and type of workplace (practice vs hospital). Differences between groups were assessed with a chi-square test for categorical data. Results: A total of 208 participants answered the questionnaire (166/208, 79.8% male), of whom 70.2% (146/208) were younger than 60 years and 77.4% (161/208) worked in a practice. All participants stated that they use SM for private and professional purposes. On average, participants used 1.6 SM platforms for professional purposes. More than half had separate SM accounts for private and professional use. The most frequently used SM platforms were messenger apps (119/200, 59.5%), employment-oriented SM (60/200, 30%), and YouTube (54/200, 27%). All other SM, including Facebook and Instagram, were only used by a minority of the participants. Women and younger participants were more likely to use Instagram (P<.001 and P=.03, respectively). The participants working in a hospital were more likely to use employment-oriented SM (P=.02) and messenger apps (P=.009) than participants working in a practice. In a professional context, 20.2% (39/193) of the participants produced their own content on SM, 24.9% (48/193) used SM daily, 39.9% (77/193) used SM during work, and 13.8% (26/188) stated that they checked the number of followers they had. Younger participants were more likely to have participated in professional SM training and to have separate private and professional accounts (P=.04 and P=.02, respectively). Younger participants tended toward increased production of their own content (P=.06). Conclusions: SM is commonly used for professional purposes by orthopedic and trauma surgeons in Germany. However, it seems that professional SM use is not exploited to its full potential, and a structured implementation into daily professional work routines is still lacking. SM can have a profound impact on medical practices and communication, so orthopedic and trauma surgeons in Germany should consider increasing their SM presence by actively contributing to SM.

BACKGROUND Social media (SM) has gained importance in the health care sector as a means of communication and a source of information for physicians and patients. However, the scope of professional SM use by orthopedic and trauma surgeons remains largely unknown. OBJECTIVE This study presents an overview of professional SM use among orthopedic and trauma surgeons in Germany in terms of the platforms used, frequency of use, and SM content management. METHODS We developed a web-based questionnaire with 33 variables and 2 separate sections based on a review of current literature. This study analyzed the first section of the questionnaire and included questions on demographics, type of SM used, frequency of use, and SM content management. Statistical analysis was performed using SPSS (version 26.0). Subgroup analysis was performed for sex, age groups (<60 years vs ≥60 years), and type of workplace (practice vs hospital). Differences between groups were assessed with a chi-square test for categorical data. RESULTS A total of 208 participants answered the questionnaire (166/208, 79.8% male), of whom 70.2% (146/208) were younger than 60 years and 77.4% (161/208) worked in a practice. All participants stated that they use SM for private and professional purposes. On average, participants used 1.6 SM platforms for professional purposes. More than half had separate SM accounts for private and professional use. The most frequently used SM platforms were messenger apps (119/200, 59.5%), employment-oriented SM (60/200, 30%), and YouTube (54/200, 27%). All other SM, including Facebook and Instagram, were only used by a minority of the participants. Women and younger participants were more likely to use Instagram (P<.001 and P=.03, respectively). The participants working in a hospital were more likely to use employment-oriented SM (P=.02) and messenger apps (P=.009) than participants working in a practice. In a professional context, 20.2% (39/193) of the participants produced their own content on SM, 24.9% (48/193) used SM daily, 39.9% (77/193) used SM during work, and 13.8% (26/188) stated that they checked the number of followers they had. Younger participants were more likely to have participated in professional SM training and to have separate private and professional accounts (P=.04 and P=.02, respectively). Younger participants tended toward increased production of their own content (P=.06). CONCLUSIONS SM is commonly used for professional purposes by orthopedic and trauma surgeons in Germany. However, it seems that professional SM use is not exploited to its full potential, and a structured implementation into daily professional work routines is still lacking. SM can have a profound impact on medical practices and communication, so orthopedic and trauma surgeons in Germany should consider increasing their SM presence by actively contributing to SM.

The aim of this study was to evaluate the outcome of patients with a rupture of the Achilles tendon (ATR) treated percutaneously with the Dresden instrument in the hands of surgeons others than its inventors. 118 patients (FU rate: 77.1%) with an acute ATR treated with the Dresden instrument were retrospectively evaluated. The following data were evaluated: pain intensity, functional limitation, Hannover score, Achilles tendon total rupture score (ATRS), AOFAS ankle-hindfoot score, Tegner activity score, complications, maximum calf circumference (MCC) on both sides, and the Matles test for tendon lengthening. The effect of the time point of the surgery after trauma was examined. Hannover scores and ATRSs were good; AOFAS scores were excellent. Almost all patients returned to sporting activities postoperatively, and 66.1% were able to return to their previous level. The Tegner activity score revealed a slight posttraumatic decrease (p = 0.009) in the level of physical activity overall (pre-injury: 5.37 ± 0.15; postoperatively: 4.77 ± 0.15). The re-rupture rate was 2%. No sural nerve lesions and no infections were reported. Even after 3 years, there was still a difference in MCC that was correlated with inferior clinical score and AT lengthening. Patients treated within the first 2 days after ATR showed inferior clinical outcomes in terms of AOFAS score, ATRS, and functional limitations. Percutaneous ATR suture with the Dresden instrument is a safe and reliable method. Low complication and re-rupture rates, good clinical results, and a high rate of return to play support this fact. The time point of the operation may influence the outcome.