{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:05Z","timestamp":1787755265706,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,11,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Few studies have evaluated the effect of resident participation on morbidity and mortality after orthopaedic trauma surgery. The goal of this study was to evaluate whether complications after orthopaedic trauma procedures involving residents correlate with the level of resident training and the timing in the academic year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent operative fixation of proximal femoral fractures, femoral shaft fractures, and tibial shaft fractures from 2005 to 2012. A total of 1,851 cases with resident involvement were identified, and complication rates were calculated and analyzed with respect to resident level of training (postgraduate year [PGY] 1 through 6) and the academic quarter in which the procedure took place.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The composite complication rates in the first academic quarter for serious adverse events (10.96%), any adverse events (18.57%), and surgical complications (9.62%) did not significantly differ from those during the remainder of the year (11.40%, 17.81%, and 7.19%, respectively). The rates of any adverse event were significantly higher for senior-level residents (quarter 1, 20.58%; quarter 2, 20.05%) than for junior residents (quarter 1, 11.76%; quarter 2, 12.44%) during the first half of the academic year (quarter 1, p = 0.044; quarter 2, p = 0.024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This evaluation of the composite complication rates found no \u201cJuly effect\u201d in lower-extremity orthopaedic trauma surgery. There was evidence for a July effect for superficial surgical site infections, in that there was a significantly higher rate in the first academic quarter. Senior residents may benefit from more oversight or instruction during the first portion of the academic year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.18.00279","type":"journal-article","created":{"date-parts":[[2018,11,22]],"date-time":"2018-11-22T14:27:05Z","timestamp":1542896825000},"page":"1919-1925","source":"Crossref","is-referenced-by-count":11,"title":["The Effect of Time During the Academic Year or Resident Training Level on Complication Rates After Lower-Extremity Orthopaedic Trauma Procedures"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7342-6948","authenticated-orcid":false,"given":"Aaron J.","family":"Casp","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-3786","authenticated-orcid":false,"given":"Brendan M.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3517-6589","authenticated-orcid":false,"given":"Seth R.","family":"Yarboro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6916-368X","authenticated-orcid":false,"given":"Josh N.","family":"Tennant","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,11,21]]},"reference":[{"issue":"5","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1097\/00000658-199705000-00002","article-title":"William Stewart Halsted. Our surgical heritage","volume":"225","author":"Cameron","year":"1997","journal-title":"Ann Surg."},{"issue":"7","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.2106\/JBJS.N.00159","article-title":"Demonstrating the value of orthopaedic surgery through multicenter trials: AOA critical issues","volume":"97","author":"Hilibrand","year":"2015","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/SLA.0b013e3181ae332a","article-title":"Implementation of resident work hour restrictions is associated with a reduction in mortality and provider-related complications on the surgical service: a concurrent analysis of 14,610 patients","volume":"250","author":"Privette","year":"2009","journal-title":"Ann Surg."},{"issue":"3","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/SLA.0b013e31814855f2","article-title":"Seasonal variation in surgical outcomes as measured by the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP)","volume":"246","author":"Englesbe","year":"2007","journal-title":"Ann Surg."},{"issue":"1","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00264-010-0950-7","article-title":"Learning curves in hip fracture surgery","volume":"35","author":"Bjorgul","year":"2011","journal-title":"Int Orthop."},{"issue":"3","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.amjsurg.2011.08.015","article-title":"Does resident involvement effect surgical times and complication rates during laparoscopic appendectomy for uncomplicated appendicitis? An analysis of 16,849 cases from the ACS-NSQIP","volume":"203","author":"Advani","year":"2012","journal-title":"Am J Surg."},{"issue":"3","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1097\/SLA.0b013e318265812a","article-title":"Impact of resident participation in surgical operations on postoperative outcomes: National Surgical Quality Improvement Program","volume":"256","author":"Kiran","year":"2012","journal-title":"Ann Surg."},{"issue":"2","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jsurg.2011.08.003","article-title":"Assessing trainee impact on operative time for common general surgical procedures in ACS-NSQIP","volume":"69","author":"Papandria","year":"2012","journal-title":"J Surg Educ."},{"issue":"3","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.jvs.2011.06.122","article-title":"Surgical trainee participation during infrainguinal bypass grafting procedures is associated with increased early postoperative graft failure","volume":"55","author":"Scarborough","year":"2012","journal-title":"J Vasc Surg."},{"issue":"6","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1097\/01.sla.0000164076.82559.72","article-title":"Does resident post graduate year influence the outcomes of inguinal hernia repair?","volume":"241","author":"Wilkiemeyer","year":"2005","journal-title":"Ann Surg."},{"issue":"15","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.2106\/JBJS.M.00660","article-title":"Impact of resident involvement on orthopaedic surgery outcomes: an analysis of 30,628 patients from the American College of Surgeons National Surgical Quality Improvement Program database","volume":"96","author":"Edelstein","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/SLA.0b013e3181b4148f","article-title":"Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals","volume":"250","author":"Hall","year":"2009","journal-title":"Ann Surg."},{"issue":"6","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/j.jamcollsurg.2007.03.024","article-title":"Use of National Surgical Quality Improvement Program data as a catalyst for quality improvement","volume":"204","author":"Rowell","year":"2007","journal-title":"J Am Coll Surg."},{"issue":"7","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.arth.2014.02.008","article-title":"The \u201cJuly effect\u201d in primary total hip and knee arthroplasty: analysis of 21,434 cases from the ACS-NSQIP database","volume":"29","author":"Bohl","year":"2014","journal-title":"J Arthroplasty."},{"issue":"7","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/BRS.0000000000000196","article-title":"\u201cJuly effect\u201d in elective spine surgery: analysis of the American College of Surgeons National Surgical Quality Improvement Program database","volume":"39","author":"Bohl","year":"2014","journal-title":"Spine (Phila Pa 1976)."},{"issue":"10","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1016\/j.arth.2014.06.003","article-title":"Resident involvement does not influence complication after total hip arthroplasty: an analysis of 13,109 cases","volume":"29","author":"Haughom","year":"2014","journal-title":"J Arthroplasty."},{"issue":"7","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1016\/j.arth.2014.02.036","article-title":"Does resident involvement impact post-operative complications following primary total knee arthroplasty? An analysis of 24,529 cases","volume":"29","author":"Haughom","year":"2014","journal-title":"J Arthroplasty."},{"issue":"5","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.surg.2005.08.016","article-title":"The NSQIP: a new frontier in surgery","volume":"138","author":"Khuri","year":"2005","journal-title":"Surgery."},{"issue":"2","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2106\/JBJS.16.01611","article-title":"Resident participation in fixation of intertrochanteric hip fractures: analysis of the NSQIP database","volume":"100","author":"Neuwirth","year":"2018","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1007\/s00402-013-1841-3","article-title":"The impact of resident involvement on post-operative morbidity and mortality following orthopaedic procedures: a study of 43,343 cases","volume":"133","author":"Schoenfeld","year":"2013","journal-title":"Arch Orthop Trauma Surg."},{"issue":"7","key":"bib22-20230810","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1007\/s11999-014-3567-0","article-title":"The effect of resident participation on short-term outcomes after orthopaedic surgery","volume":"472","author":"Pugely","year":"2014","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jamcollsurg.2011.03.014","article-title":"Surgical resident involvement is safe for common elective general surgery procedures","volume":"213","author":"Tseng","year":"2011","journal-title":"J Am Coll Surg."},{"issue":"2","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jss.2005.11.578","article-title":"Influence of resident and attending surgeon seniority on operative performance in laparoscopic cholecystectomy","volume":"132","author":"Kauvar","year":"2006","journal-title":"J Surg Res."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201811210-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:40:21Z","timestamp":1787751621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201811210-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,21]]},"references-count":23,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.18.00279","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,21]]}}}