OBJECTIVE: Hardware prominence is the most common cause of reoperation in patients who have undergone tension band wiring for fractures of the olecranon. The study was conducted to compare the strength of four different constructs of tension band wiring of the olecranon.
METHODS: A transverse fracture was created in twenty cadaveric ulnas which were equally divided into four groups according to the method of fixation: 1-Single tension band, transcortical k-wire fixation; 2-Single tension band, intramedullary k-wire fixation; 3-Double tension band, transcortical k-wire fixation; 4-Double tension band, intramedullary k-wire fixation. All specimens were mounted on a universal testing machine using a custom-made fixation jig. They were tested under a single cycle load to failure. The maximum failure load was measured for all specimens.
RESULTS: There was no significant difference in the maximum load to failure among the four treatment groups.
CONCLUSION: No differences in the maximum load to failure noted in between treatment groups, regardless if single or double tension band wiring was done, and regardless if k-wire fixation was transcortical or medullary. These findings would support the argument that any of the desired fixation methods may be used.

OBJECTIVES: To determine the incidence of MRSA among admitted hand patients at UP-PGH from 2005 to 2010 and determine the antibiotic susceptibility pattern.

METHODS: Records of admitted hand patients of all ages were identified and wound culture results were reviewed. A total of 482 wound cultures from the S-year period were examined.

RESULTS AND CONCLUSION: From an initial decreasing trend, there was a sharp increase in incidence of MRSA hand infections from 2008 (11.8%) to 2009 (22.5%).Vancomycin had the highest number of susceptible cases from 2005 to 2008, but dropped quite sharply to the least number of susceptible cases in 2010. Chloramphenicol and erythromycin had the highest number of susceptible MRSA hand cases in recent years.

OBJECTIVES: Implants for traumatic orthopedic injuries are costly, and usually borne by the patient. We determined whether a consignment policy decreases morbidity and mortality rates, decreases length of stay, and decreases total expenditure of our patients. METHODS: This is an ambispective cohort study comparing patients whose orthopedic implant surgeries were done before consignment policy and thus paid for out-of-pocket (Group A), and patients whose surgeries were done under the policy, and whose implants were paid for by hospital funding (Group B). Patient records and hospital bills were reviewed. A total of 206 patients were included in the study, and we gathered data from department and hospital records regarding the incidence of morbidity, mortality, length of stay, and total hospital expenditure. RESULTS: In this study, we demonstrate no difference in the incidence of morbidities and mortalities between the two groups. There was also no significant difference in the total hospital expenditure of both. There is a slightly shorter preoperative stay, and significantly longer postoperative and total hospital stays for Group B patients. CONCLUSION The consignment policy, in its first year of implementation, demonstrated no difference in the incidence of morbidity and mortality, or total hospital expenditures. Further long-term studies may be undertaken to improve accuracy of results.

OBJECTIVES: This study aimed to compare the evaluation results of University of the Philippines - College of Medicine (UPCM) Learning Unit VI (LU VI) students in their Musculoskeletal (MSK) year-end module examination and final module grade to their results in the MSK 30 examination. It likewise sought to assess the adequacy of the institution’s current curriculum on the basis of the most clinically relevant MSK topics included in the MSK 30. METHODS: The knowledge of the students in Musculoskeletal medicine was determined using the MSK 30 validated exam and this was compared to their results in the various evaluation tools of the present MSK curriculum. The results were subjected to statistical analysis using (1) the Pearson correlation coefficient and (2) item analysis. RESULTS: Despite exhibiting above average performance in the MSK module, the performance of the 66 (N=187) LU VI students in the MSK 30 showed otherwise with a passing rate of only 48.48%. There was no statistically significant correlation between the MSK 30 and the year-end module examination (p value = 0.77, CI 90%, ME 8%), and the final module grade (p value = 0.92, CI 90%, ME 8%). It was noted that the students did poorly in the following topics: Environmental Injury, Head Injury, Infection, Pediatrics, Spine, and Sports Injuries. CONCLUSION Undergraduate medical students of the University of the Philippines - College of Medicine performed poorly in the MSK 30 despite a generally good performance in the prescribed MSK module. Whether this is indicative of inadequacies in the existing MSK curriculum or is due to the MSK 30 not being appropriate to the local setting will need to be determined.

OBJECTIVES: The objectives of the study were to determine the resident-physicians’ perspectives with regards the changes implemented in their Hand Surgery rotation at the Philippine General Hospital in response to the COVID-19 pandemic, and establish correlation, if any, of these perspectives to their performance in the said rotation based on their final grades. METHODS: Thirteen (13) residents were chosen for the study, all of which had rotated with the division at least once after the implementation of the changes were made, to answer an online survey and participate in an online group discussion, focusing on their feedback on the effects of these changes in terms of their skills and overall patient care. RESULTS: In general, the participants agreed strongly to the usefulness of the hybrid set-up with Likert survey answers ranging from 3.5 to 4 points in favor of the changes implemented. Eleven of the 13 participants had their mean survey answer scores matched with their respective grades obtained during his/her rotation with the division, showing no correlation. CONCLUSION The study showed a generally positive perception by the orthopedic residents to the hybrid set-up in the Hand Surgery rotation in response to the COVID-19 pandemic. No clear correlations or trends were seen between the trainees’ perceptions of the changes implemented and his/her objective performance based on the final grade for his/her rotation. Potential topics for investigation related to this may focus on using larger sample size or clinical outcomes of cases done by trainees who have undergone the hybrid training set-up.

OBJECTIVE: The study aims to assess the similarity between the results of the evaluation of students during an Objective Structured Clinical Examination (OSCE) and a video recording of the same OSCE (VOSCE). METHODS: All Orthopedic surgeon preceptors in the actual OSCE were recruited to the study. Video recordings of the students taking the OSCE were collected and later reviewed and re-evaluated by the same preceptor after at least four weeks. The grades of actual OSCE and VOSCE were collected and analyzed using Cohen’s kappa coefficient. RESULTS: High variability of intra-rater reliability was observed in different preceptors and station (slight agreement to perfect agreement). Overall intra-rater reliability between actual and video OSCE showed moderate agreement with Cohen’s kappa coefficient equal to 0.43 (n-219). CONCLUSION: Video OSCE is a reliable tool in assessing student clinical skills and knowledge in the musculoskeletal examination. Some factors have been suggested to further improve reliability.
Video Recording

OBJECTIVE: The study aims to assess the similarity between the results of the evaluation of students during an Objective Structured Clinical Examination (OSCE) and a video recording of the same OSCE (VOSCE). METHODS: All Orthopedic surgeon preceptors in the actual OSCE were recruited to the study. Video recordings of the students taking the OSCE were collected and later reviewed and re-evaluated by the same preceptor after at least four weeks. The grades of actual OSCE and VOSCE were collected and analyzed using Cohen’s kappa coefficient. RESULTS: High variability of intra-rater reliability was observed in different preceptors and station (slight agreement to perfect agreement). Overall intra-rater reliability between actual and video OSCE showed moderate agreement with Cohen’s kappa coefficient equal to 0.43 (n-219). CONCLUSION: Video OSCE is a reliable tool in assessing student clinical skills and knowledge in the musculoskeletal examination. Some factors have been suggested to further improve reliability.
Osteosarcoma

Background: In the face of the COVID-19 pandemic and a country-wide lockdown, the University of the Philippines College of Medicine halted face-to-face teaching in exchange for online learning for its students. For the Learning Unit VI students, clinical rotations shifted to hybrid activities to continue learning activities while minimizing exposure risk. The Philippine General Hospital Department of Orthopedics introduced the following hybrid activities in its curriculum for Learning Unit VI students: 1) Online Lectures, 2) Online Departmental Conference, 3) Online Division Rounds, 4) Online SGDs, 5) Written Case, 6) Online Exams, 7) Preceptorship, Demo, Return Demo, and 8) Online OSCE. The department used a variety of platforms including synchronous sessions, asynchronous pre-recorded lectures, and face-to-face teaching, as appropriate. Objectives: The study compared the faculty and student course evaluations of activities in the hybrid ORTHO 251 course. Methodology: Faculty and students were asked to evaluate each activity according to the Course Evaluation By Students (CEBS), the standard questionnaire used by the college, to determine the overall rating of each activity as well as any differences between the two groups. Results: The hybrid activities conducted in the ORTHO 251 course were rated as good or excellent by the faculty and students, with differences in a few activities. Consultants rated online exams as being less effectively integrated and that there was inadequate time allotment for online SGDs, written cases, and online exams. Meanwhile, students rated all activities higher in terms of stimulating self-directed learning. Conclusion With good to excellent outcomes, this study found that it has at least satisfactorily matched the learning platform to the learning component. While knowledge may be taught via asynchronous recorded lectures or reading materials, attitude and thinking processes are better formed through synchronous discussion. Skills in medical education, including Orthopedics, are still best taught via face-to-face demoreturn demo. With this information, the department can investigate the causes of these differences and improve on the identified weaknesses.
Orthopedics

Background: In the face of the COVID-19 pandemic and a country-wide lockdown, the University of the Philippines College of Medicine halted face-to-face teaching in exchange for online learning for its students. For the Learning Unit VI students, clinical rotations shifted to hybrid activities to continue learning activities while minimizing exposure risk. The Philippine General Hospital Department of Orthopedics introduced the following hybrid activities in its curriculum for Learning Unit VI students: 1) Online Lectures, 2) Online Departmental Conference, 3) Online Division Rounds, 4) Online SGDs, 5) Written Case, 6) Online Exams, 7) Preceptorship, Demo, Return Demo, and 8) Online OSCE. The department used a variety of platforms including synchronous sessions, asynchronous pre-recorded lectures, and face-to-face teaching, as appropriate. Objectives: The study compared the faculty and student course evaluations of activities in the hybrid ORTHO 251 course. Methodology: Faculty and students were asked to evaluate each activity according to the Course Evaluation By Students (CEBS), the standard questionnaire used by the college, to determine the overall rating of each activity as well as any differences between the two groups. Results: The hybrid activities conducted in the ORTHO 251 course were rated as good or excellent by the faculty and students, with differences in a few activities. Consultants rated online exams as being less effectively integrated and that there was inadequate time allotment for online SGDs, written cases, and online exams. Meanwhile, students rated all activities higher in terms of stimulating self-directed learning. Conclusion With good to excellent outcomes, this study found that it has at least satisfactorily matched the learning platform to the learning component. While knowledge may be taught via asynchronous recorded lectures or reading materials, attitude and thinking processes are better formed through synchronous discussion. Skills in medical education, including Orthopedics, are still best taught via face-to-face demoreturn demo. With this information, the department can investigate the causes of these differences and improve on the identified weaknesses.
Orthopedics ; Education, Distance ; Education, Medical

Introduction: Caffeine use disorder (CUD), a problematic caffeine use pattern, is yet to be recognized under DSM-5 and is under consideration for further research. This study aimed to determine if the sex, employment status, and smoking status of Quezon City residents aged 18 years old and above are associated with CUD, and to determine the mean daily caffeine consumption (MDCC) of caffeinated products and the proportion of individuals meeting the CUD criteria. Methods: A total of 334 respondents accomplished the online survey that collected socio-demographic information and evaluated CUD using an 8-point Caffeine Consumption Questionnaire (CCQ). Results: The study population was mostly composed of females, unemployed, and non-smokers. Results showed that 17% of respondents have CUD, that brewed coffee was most consumed daily, the MDCC of the study population was 158.31 mg; and females were at an increased risk for CUD, while nonsmokers and unemployed individuals were at reduced risk. Conclusion The proportion of Quezon city residents that have CUD is at 17%, consuming an average of 158.31 mg of coffee daily, with brewed coffee being consumed most. Female residents are at an increased risk of having CUD, while nonsmokers and unemployed individuals are at a decreased risk.
Caffeine ; Coffee ; Cross-Sectional Studies ; Diagnostic and Statistical Manual of Mental Disorders