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 pediatr...

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Main Authors: Joleen Weissert, MD, MPH, Rebecca Vieira, MD, Claire White, MD, Lanna Feldman, Megan Hannon, MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of the Pediatric Orthopaedic Society of North America
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Online Access:http://www.sciencedirect.com/science/article/pii/S2768276525000458
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author Joleen Weissert, MD, MPH
Rebecca Vieira, MD
Claire White, MD
Lanna Feldman
Megan Hannon, MD
author_facet Joleen Weissert, MD, MPH
Rebecca Vieira, MD
Claire White, MD
Lanna Feldman
Megan Hannon, MD
author_sort Joleen Weissert, MD, MPH
collection DOAJ
description 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
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spelling doaj-art-fbca1745fe51434bb1b443c4cba1ed312025-08-20T02:38:41ZengElsevierJournal of the Pediatric Orthopaedic Society of North America2768-27652025-08-011210020110.1016/j.jposna.2025.100201Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care CenterJoleen Weissert, MD, MPH0Rebecca Vieira, MD1Claire White, MD2Lanna Feldman3Megan Hannon, MD4Corresponding author: 7 Gloucester Street, Boston, Ma 02115, USA.; Boston Children's Hospital, Boston, MA, USABoston Children's Hospital, Boston, MA, USABoston Children's Hospital, Boston, MA, USABoston Children's Hospital, Boston, MA, USABoston Children's Hospital, Boston, MA, USABackground: 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 studyhttp://www.sciencedirect.com/science/article/pii/S2768276525000458Pediatric orthopaedic medicineScope of practiceCurriculum developmentNon-operative pediatric orthopaedics
spellingShingle Joleen Weissert, MD, MPH
Rebecca Vieira, MD
Claire White, MD
Lanna Feldman
Megan Hannon, MD
Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center
Journal of the Pediatric Orthopaedic Society of North America
Pediatric orthopaedic medicine
Scope of practice
Curriculum development
Non-operative pediatric orthopaedics
title Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center
title_full Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center
title_fullStr Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center
title_full_unstemmed Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center
title_short Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center
title_sort scope of practice for pediatric orthopaedic medicine at a tertiary care center
topic Pediatric orthopaedic medicine
Scope of practice
Curriculum development
Non-operative pediatric orthopaedics
url http://www.sciencedirect.com/science/article/pii/S2768276525000458
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