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Musculoskeletal Pain in Cleft Surgeons and Orthodontists

Justine Kim MD Wendy Chen MD Jack Brooker MB, BChir Christopher Bise PT, MS Lorelei Grunwaldt MD Joseph Losee MD Lindsay Schuster DMD, MS
University of Pittsburgh Medical Center
2019-02-13

Presenter: Justine Kim

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. And that the work presented here is the resident's original work.

Director Name: Vu Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Background
Every ten degrees of neck flexion increases the effective weight of the head by ten pounds, accelerating degenerative changes in the cervical spine. Literature regarding occupational hazards specific to cleft providers is lacking. We aim to determine the prevalence and characteristics of musculoskeletal pain and pathology in cleft surgeons and orthodontists.

Methods
This was an IRB-exempt survey based on previously validated musculoskeletal surveys and sent to ACPA-approved team coordinators internationally. Descriptive data and correlations were assessed and compared to published data in comparative populations.

Results
There were 83 respondents. 90% reported MSK symptoms, a greater incidence than in general plastic surgeons. 63% reported headaches, higher than the general population. Of 12 body parts surveyed, the most commonly affected were the neck (71%), shoulders (53%), and lower back (68%). Pain interfered with hobbies and home life in 63% of respondents. Males were more likely to have more frequent and severe neck (p = 0.02, 0.01) and lower back pain (p = 0.04, < 0.01). Left handed providers were more likely to have more severe elbow pain (p = 0.02). Those who reported formal diagnoses were more likely to undergo treatment including surgery (p < 0.01), medication (p = 0.03) and physical therapies (p < 0.01).

Conclusion
Cleft surgeons and orthodontists experience a higher frequency of headaches and musculoskeletal pain compared to the general plastic surgeon. Moreover, data demonstrates that formal diagnoses may lead to interventions. Our findings may guide the cleft clinician to be mindful of ergonomics and personal wellness.

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