Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center.

[BACKGROUND] Pediatric orthopaedic medicine (alternatively/formerly known as non-operative pediatric orthopaedics, NOPO) is an emerging specialty within orthopedics with limited published descriptive studies. This is a retrospective descriptive study of all patient encounters managed by three pediatric orthopedic medicine physicians at a single institution over a five-year period (2019-2024).

[METHODS] Data from an internal hospital database were analyzed to determine the volume of patients seen, diagnoses managed, and surgical referral patterns. A total of 31,216 patient encounters were analyzed.

[RESULTS] The top diagnoses managed by this group include: acute fracture (all body locations) 24.8% (n=15,019), scoliosis 10.9% (n=6,713), abnormal gait and mobility 7.9% (n=4,558), lower limb alignment 6.9% (n=4,176), joint disorders 6.9% (n=4,135), congenital hip deformities 5.9 % (n=3,453), congenital foot deformities 4% (n=2,442), pain, soft tissue 4% (n= 2,326), developmental delay 4 % (n=2,147), and dorsalgia 2% (n=1,173). Of the unique patients in the dataset 96% were managed medically and 4% had surgery related to their initial diagnosis. The top surgical procedures were: knee surgeries (14.8%), upper extremity pinning/reduction (14.6%), spinal fusion (7%), hip open/closed reduction (6.2%), Achilles lengthening (6.2%), Botox/phenol injection (5.9%), and lower extremity epiphysiodesis (3%).

[CONCLUSIONS] Data from this study provide insight into the unique role pediatric orthopedic medicine physicians play in the pediatric orthopedic community and can help guide curriculum development for future trainees.

[KEY CONCEPTS] (1)Pediatric orthopaedic medicine is an emerging specialty within orthopaedics with limited published descriptive studies.(2)Pediatric orthopaedic medicine physicians manage a wide range of orthopaedic conditions traditionally managed by surgical colleagues.(3)In an increasingly specialized pediatric orthopaedic workforce, pediatric orthopaedic medicine physicians can serve as a medical home for many nonsurgical orthopaedic conditions.(4)A formal curriculum for pediatric orthopaedic medicine training should be developed with a goal toward ACGME accreditation of fellowships.

[LEVEL OF EVIDENCE] Retrospective cohort study.