National Trends in Carpal Tunnel Release and Hand Fracture Procedures Performed During Orthopaedic Residency: An Analysis of ACGME Case Logs

Abstract

BACKGROUND: Mastery in performing carpal tunnel release (CTR) and hand fracture procedures is an essential component of orthopaedic residency training. OBJECTIVE: To assess orthopaedic resident case log data for temporal trends in CTR and hand fracture cases and to determine the degree of variability in case volume among residents. METHODS: Accreditation Council for Graduate Medical Education orthopaedic surgery resident case logs were reviewed for graduation years 2007 through 2014. Annual data regarding the mean number of CTR and hand fracture/dislocation procedures were recorded, as well as the median number of procedures reported by the top and bottom 10% of residents (by case volume). Temporal trends were assessed using linear regression modeling. RESULTS: There was no change in the mean number of CTRs performed per resident. Over the 8-year period, the top 10% of residents performed a significantly greater number of CTRs than the bottom 10% (62.1 versus 9.3, P < .001). CONCLUSIONS: Our results indicate no change in CTR and hand fracture caseload for orthopaedic residents. However, as resident experience performing both procedures varies significantly, this variability likely has important educational implications.