Trends In Management Research Articles

Surgical Management of Fibroids: A Changing Landscape.

Background: Uterine fibroids affect patients' quality of life and contribute significantly to health care costs. Studies from 2009 to 2011 demonstrated that fibroids disproportionately affect Black women, with lower odds of uterine preservation and minimally invasive approaches. Objective: This is a retrospective cohort study of data abstracted from the National Surgical Quality Improvement Program database from 2015 to 2019 examining trends in surgical management of uterine fibroids and exploring disparities in surgical approach in a modern cohort. Results: In total, 52,909 women underwent hysterectomy and 15,485 women underwent myomectomy between 2015 and 2019. Over the study period, the overall number of surgeries for fibroids increased by 44.2% with minimally invasive hysterectomy responsible for the majority of this increase. The proportion of patients who underwent myomectomy significantly increased (20.85% to 24.62%, p value <0.0001), whereas hysterectomy significantly decreased (79.15% to 75.38%, p value <0.0001). Bivariate analysis identified younger age, non-White race, and body mass index (BMI) <25 as significantly associated with performance of myomectomy. Non-Hispanic Black (adjusted odds ratio [aOR]: 3.55, 95% confidence interval [CI]: 3.23-3.89), Asian (aOR: 3.26, 95% CI: 2.80-3.80), and Hispanic Black (aOR: 5.50, 95% CI: 3.29-9.25) women were more likely to undergo myomectomy than non-Hispanic White women. Conclusion: Surgical treatment for fibroids increased over time, shifting toward uterine preservation. Myomectomy performance is associated with lower age and BMI and identifying as a racial and/or ethnic minority. These trends may represent improved access to surgical treatment of fibroids, resulting from the growth of minimally invasive gynecological surgery as a specialty and advocacy for equitable health care for all patients.

Assessing Information Technology in Hospitals in Tehran: Challenges and Opportunities for Performance Improvement

Purpose: This research aimed to investigate the maturity level of information technology (IT) within hospitals in Tehran. Method: The study was applied in purpose and survey-based in method. The statistical population comprised 27 experts in urban management and IT within hospitals in Tehran. A revised standard questionnaire, based on Gartner’s IT management process maturity model, was used to measure IT maturity. Data analysis was performed using SPSS software (version 23). Findings: The study revealed that several aspects of IT maturity within hospitals in Tehran were generally favorable. Specifically, leadership and IT management activities, customer-oriented service, control and evaluation, configuration and asset management, security management, change management, service level management, accessible management, service and support documentation, capacity management, and strategic trends were positively evaluated. However, operations management, human resource management, supplier management, and certain IT service management components were found to be below the average level of 3. Conclusion: Overall, the research indicates that the IT maturity level in hospitals in Tehran is largely favorable. Nevertheless, improvements are needed in specific areas, such as operations management and human resource management, to enhance the effectiveness and efficiency of IT operations.

Survival outcomes of adjuvant treatment in upstaged clinical T2N0 rectal cancer: are we underutilizing therapy?

BackgroundPatients with rectal cancer staged as clinical T2N0 (cT2N0) are recommended to undergo upfront resection. However, when the tumor is subsequently upstaged to pathologic T3N0 (pT3N0), there are no clear guidelines for adjuvant treatment. This study aimed to analyze national trends in adjuvant management and to identify differences in morbidity or survival. MethodsUsing the National Cancer Database (2004–2020), adult patients with cT2N0 rectal adenocarcinoma that were upstaged to pT3N0 after resection were identified. The treatment groups included (i) surgery alone, (ii) surgery + postoperative (post-op) chemotherapy alone, (iii) surgery + post-op chemoradiation (CRT), and (iv) surgery + chemotherapy + CRT. Cox proportional hazard models and Kaplan-Meier curves (6-month landmark analysis) were used to compare survival outcomes. ResultsThe analytic cohort included 800 patients who received the following treatments: surgery alone (496 [60%]), surgery + post-op chemotherapy (139 [17%]), surgery + post-op CRT (137 [15%]), and surgery + chemotherapy + CRT (69 [8%]). Patients who underwent post-op chemotherapy or chemotherapy + CRT had higher rates of poor/undifferentiated tumors (15.7% and 15.4%, respectively) than those who underwent surgery alone (8.8%) (P = .047). Over the study period, surgery alone decreased from 86.7% to 65.6%, with concomitant increases in post-op adjuvant therapy. Post-op chemotherapy (hazard ratio [HR], 0.336; 95% CI, 0.196–0.575) and chemotherapy + CRT (HR, 0.447; 95% CI, 0.231–0.866) remained independently associated with improved overall survival. Of note, 5-year survival was the lowest in the surgery-alone group (62.5%). ConclusionPost-op adjuvant regimens, including chemotherapy, were independently associated with improved survival in patients with cT2N0 rectal cancer upstaged to pT3N0. Adjuvant therapy may be underutilized in this setting.

Exploring determining factors of MaaS app use and its potential effects on mobility behavior: Keys to gender-sensitive planning and management

Mobility as a Service (MaaS) has become an emerging trend in transportation planning and management due to its potential to overcome the challenges of urban mobility toward the achievement of sustainable mobility goals. This requires people to be willing to use MaaS apps. However, given their relative novelty, there is still a lack of research on the factors that influence the use of these apps, as well as the possible role of gender in such use. In this context, this study aims to explore the complex relationships between a set of relevant factors and their influence on the intention to adopt MaaS apps, with special attention to the role of gender as a moderating variable. For this purpose, a survey was conducted in the Madrid Metropolitan Area (Spain), comprising 8358 respondents (3627 men and 4731 women), and a four-step methodological procedure was adopted: (i) Exploratory Factor Analysis (EFA), (ii) Confirmatory Factor Analysis (CFA), (iii) Structural Equation Model (SEM) on the total sample (iv) Gender-sensitive analysis, including a Multi-group analysis – SEM. The results demonstrate that technophilia, perceived usefulness and perceived ease of use are determining factors. Green values and attitudes toward shared modes have a notable total positive effect. However, contrary to expected, attitudes toward public transport, car and bicycle hardly explain the intention to adopt MaaS apps. Our analysis also reveals significant gender differences in the causal relationships hypothesized in the model. These findings allow us to outline the policy initiatives that could favor the use of MaaS apps, with a gender-sensitive approach.

Trends and Factors Influencing Surgical Choices for Femoral Neck Fractures

Introduction: Femoral neck fractures pose significant health risks, particularly in the elderly population, leading to mortality, morbidity, and decreased quality of life. Surgery is the preferred treatment to restore function and alleviate pain, with options including total hip arthroplasty (THA) and hemiarthroplasty (HA). However, clinical guidelines for selecting surgical procedures remain heterogeneous, prompting the need for further investigation into treatment trends and influencing factors. Methods: Data from the NIS database spanning 2016–2019 were analyzed, focusing on patients diagnosed with intracapsular femoral neck fractures and undergoing THA or HA as primary in-hospital surgeries. Advanced statistical analyses using SPSS and MATLAB were conducted to identify trends and factors influencing surgical choices. Results: Comorbidity profiles varied significantly between HA and THA patients, with specific conditions such as Alzheimer’s disease showing higher prevalence in HA patients. Demographic differences included a higher proportion of females and Medicare-insured individuals in the HA group. Racial disparities were observed, with differences in surgical preferences among various ethnic groups. THA adoption gradually increased over the study period, indicating a shift in surgical priorities. Additionally, THA patients tended to be younger on average compared with HA patients. Conclusions: This study highlights evolving trends in surgical management for femoral neck fractures and identifies factors influencing treatment decisions in our cohort. Understanding these trends and disparities is crucial for optimizing patient care and informing future clinical guidelines. Further research should focus on assessing different surgical approaches’ long-term outcomes and cost-effectiveness.

National Trends and Outcomes in the Operative Management of Thyroid Storm.

Thyroid storm is a rare but potentially lethal manifestation of thyrotoxicosis. Guidelines recommend nonoperative management of thyroid storm, but thyroidectomy can be performed if patients fail medical therapy or need immediate resolution of the storm. Outcomes of thyroidectomy for management of thyroid storm remain ill-defined. Using the National Inpatient Sample from 2016 to 2020, a retrospective analysis was conducted of patients admitted with thyroid storm. Outcomes of interest included operative complications and mortality. Multivariable logistic regression was performed to assess factors associated with receiving thyroidectomy and mortality. An estimated 16,175 admissions had a diagnosis of thyroid storm. The incidence of thyroid storm increased from .91 per 100,000 people in 2016 to 1.03 per 100,000 people in 2020, with a concomitant increase in mortality from 2.9% to 5.3% (P < .001). Operative intervention was pursued in 635 (3.9%) cases with a perioperative complication rate of 30%. On multivariable regression, development of acute decompensated heart failure (adjusted odds ratio [AOR] 1.66, 95% Confidence Interval [CI] 1.03-2.68, P = .037) and acute renal failure (AOR 2.10, 95% CI 1.17-3.75, P = .013) increased odds of receiving surgery. The same multivariable model did not show a significant association between thyroidectomy and mortality. The incidence of thyroid storm and associated mortality increased during the study period. Thyroidectomy is rarely performed during the same admission, with an overall perioperative complication rate of 30% and no effect on mortality. Patients with acute decompensated heart failure and renal failure were more likely to receive an operative intervention.

Joint Management Plans in World Heritage serial nominations: the case of Álvaro Siza’s Modern Contextualism Legacy

One of the most important challenges faced by any listed cultural heritage is the development of a management system that conveys a resilient and integrated approach that can sustain its values for future generations. Management is one of the main factors affecting World Heritage Sites; thus, the increased complexity of a serial nomination enhances this risk. By integrating different stakeholders, a Joint Management Plan (JMP) is a key tool to settle common procedures and help different managers maintain a satisfactory balance in safeguarding the Outstanding Universal Value (OUV) in each component part. This paper aims to provide a framework for the development of JMPs for serial nominations, with support on the nomination proposal “Álvaro Siza’s Architecture: A Modern Contextualism Legacy”. Methods result from the cross-analysis of (i) policy analysis; (ii) archival research and digital documentation; (iii) collaborative strategies (surveys, interviews, workshops, meetings, consultations); (iv) fieldwork. Results confirmed that the development of JMPs must be sustained by an open and dynamic process, where engagement, mediation of conflicts, and flexibility are key principles. This work approaches a significant subject concerning the management of World Heritage serial nominations, focusing on JMPs for serial nominations, which are a rising trend in heritage management. A demonstration is applied to the WH nomination of works by Álvaro Siza, a prominent figure in worldwide contemporary architecture.

S1499 Trends in Medical and Surgical Management of Patients With Inflammatory Bowel Disease and Concomitant Human Immunodeficiency Virus Infection in the United States: A Population-Based Study

S1499 Trends in Medical and Surgical Management of Patients With Inflammatory Bowel Disease and Concomitant Human Immunodeficiency Virus Infection in the United States: A Population-Based Study

Current trends in vestibular schwannoma management at a referral center in Indonesia: A cross-sectional study with retrospective data collection

Background. Vestibular schwannoma (VS) is the most common benign brain tumor of the cerebellopontine angle. Due to its location, this pathology can create both focal and general deficits. The registry system for VS in Indonesia is developing, including in the author’s institution, which eventually shows a changing trend in managing VS. Methods. We retrospectively collected data from all patients diagnosed with vestibular schwannoma, based on histological or radiological results. Treatments included craniotomy and/or Gamma Knife Radiosurgery (GKRS) from 2018 to 2023. Results. Data from 88 patients were analyzed. The number of treated patients has increased annually. VS predominantly affects females (64%). The proportion between GKRS and craniotomy procedures also shifted throughout the year. Common symptoms included hearing loss (63.6%), disequilibrium (50%), and headaches (39.7%). The most common tumor size was medium (15-30 mm; n=37; 42%). Tumors that fell into the intrameatal and small (&lt;15 mm) categories were all treated with GKRS, whereas the other groups were divided into GKRS and craniotomy. GKRS demonstrated high efficacy in tumor control and favorable hearing and facial nerve preservation, whereas craniotomy remained crucial for larger tumors. Conclusion. The number of VS diagnosed each year has increased in our center, accompanied by a noticeable shift in preference from GKRS to craniotomy, which is influenced by the integration of intraoperative monitoring. Treatment preference was further determined based on the clinical profile and tumor size. In the future, there is a need to develop a national registry to better reflect the true incidence of VS within the Indonesian population.

The trends in diagnosis, management, and care of patients with diffuse intrinsic pontine gliomas: Perspectives from a tertiary care hospital of pakistan.

Diffuse intrinsic pontine glioma (DIPG) primarily affects pediatric patients. Data on the global incidence of DIPG remain sparse, especially in South Asia and low-middle-income countries like Pakistan. After exemption from the Ethics Review Committee, a retrospective study was conducted. Records of patients with DIPG at the Aga Khan Hospital in Karachi, from January 2010 to December 2022, were reviewed. A total of 35 pediatric patients were managed for DIPG. The median age of the patients was 9, with 19 (54.3%) males and 16 (45.7%) females. Cranial nerve palsies were the most common complaint and were present in 19 (54.3%) patients, followed by headaches in 18 (51.4%), long tract signs in 14 (40%), ataxia/cerebellar symptoms in 14 (40%), and seizures in 5 (14.3%). MRI was the primary diagnostic tool, used alone or with CT in 32 (94.1%) patients; CT alone was used in only 2 (5.7%) patients. Biopsy was performed in 10 (28.6%) patients. Primary radiation therapy was administered to 14 (40%) patients with 5400 cGy in 30 fractions. All these patients received steroids while none of them received reirradiation. VP shunt surgery for hydrocephalus was performed in 9 (25.7%) patients. Over half (54.3%) refused treatment post-diagnosis, and 71.4% were lost to follow-up. Providing timely, quality multi-disciplinary care to DIPG patients within resource constraints remains challenging in Pakistan. However, recent developments show promise for improving DIPG care in the country.

외국의 사교육 수요시장 및 수요관리 정책 동향 분석

[Purpose] The purpose of this study was to analyze foreign private tutoring demand markets and demand management policy trends. The aim was to present implications necessary for managing the domestic private tutoring market. [Methods] In this study, using 103 domestic and foreign research materials, domestic and foreign private tutoring demand markets were analyzed in terms of participation rates of private tutoring, gaps in private tutoring expenses between classes, participation backgrounds and its purposes, and response measures and policies trends for private tutoring demand management were further analyzed as well. [Results] First, the participation rate results of private tutoring over all showed increasing trends across East and West countries regardless of rich or poor, capitalist or socialist, and its more increase due to the COVID-19 pandemic. The participation rates of private tutoring was higher among students with parents in socioeconomic status, who lived in cities, and had top grades, and the gaps in private tutoring expenses between classes were a factor causing social imbalance. Second, the backgrounds and purposes of participating in private tutoring were being formed by being linked to current or changing education, social culture, economy and policy. Although they were somewhat different depending on the education systems and overall conditions of each country, there was the common ground arisen from parents' human nature and desire who wanted their children to live a stable life in the future. While the backgrounds and purposes of private tutoring participation were driven from expectations for usefulness of private tutoring, it partially led to the factor causing the harmful effects of private tutoring. Third, each government's measures and policies for private tutoring demand management were somewhat different depending on the government's perspective on private tutoring and its level of the economy, but those most representative ones included strengthening public education, expanding after-school and care services, supporting the vulnerable social group, improving tests in schools and entrance examination systems, and reforming curricula in schools. These policies lowered students' burden of learning and parents' burden of educating and raising their children, but did not produce clear results in reducing the demand for and dependence on private tutoring. [Conclusion] In order to manage the private tutoring demand market, the multifaceted and complex aspects surrounding private tutoring must be understood deeply, and realistic policies suitable for interests of individuals and their society must be established through evaluations of the harmfulness and usefulness of private tutoring.

Bibliometric Analysis of the Effectiveness of Waste Management and Recycling Programs in the Textile Industry

This bibliometric study provides a comprehensive analysis of the evolution and current trends in waste management and recycling within the textile industry, spanning from 1970 to 2024. Utilizing VOSviewer for keyword co-occurrence analysis, the research highlights a significant shift from basic waste management to advanced, sustainable practices integrated into textile production. The study reveals an increased focus on technologies such as wastewater treatment and recycling innovations, reflecting the industry's response to global sustainability demands. The findings illustrate the interdisciplinary nature of textile waste management research and underscore the importance of technological advancements in promoting environmental sustainability. However, the study also identifies ongoing challenges, including regional disparities in waste management effectiveness and the need for global standards. The study emphasizes the necessity for future research to address these challenges, proposing a continued focus on innovative, adaptable recycling technologies and comprehensive waste management strategies that can be implemented globally.

Management of innovative projects to ensure innovative development of enterprises

The subject of the study is theoretical provisions, methodology of adaptive management of innovation projects and innovative development of enterprises, methodological basis, practical proposals for its research in modern conditions. The purpose of the article is to summarize generalization of the theoretical basis of the features of innovative projects, the expediency of using organizational structures for managing the processes of their formation and implementation, analysis of adaptive methodologies for managing innovative projects to ensure the employment of workers, their innovative development, and development of practical recommendations on these issues for a working enterprise. The purpose is revealed by solving the following tasks: generalize the features of innovative projects that determine the success of their implementation; determine the feasibility of using organizational structures of enterprise management for the formation and implementation of innovative projects to ensure innovative development; identify and propose the use of adaptive management methodologies for innovative projects to achieve successful innovative development of enterprises; develop a hybrid organizational structure for innovation management; the main directions of innovative personnel management of enterprises to promote their employment and management of innovative development are proposed. To solve the tasks, the following methods were used: theoretical generalization, analysis, synthesis, induction and deduction, structural and logical analysis, systemic and situational approaches, the method of working day photography, Agile adaptive management methodology, graphic method, and the authors' own practical experience. The conclusions and results of the article are as follows: it is proved that the management of innovation projects should take into account their features, be based on the use of project, matrix and hybrid organizational management structures and the application of adaptive methodologies for managing innovation development and the formation and implementation of innovation projects, such as Agile, Scrum, Kanban, Lean. For the operating enterprise Nebozvid LLC, using adaptive management methodologies, a hybrid organizational structure of the project department has been developed to ensure the innovative development of the enterprise through the implementation of innovative projects with the organization of small project teams. The main trends in innovative personnel management of enterprises are proposed, the use of which contributes to the success of innovative project management to ensure the innovative development of enterprises.

Shaping the Future of Learning, Teaching, and School Leadership Management

This paper is about transformative trends in education, exploring learning, teaching methodologies, and management of school leadership, which will redefine education in the next ten years and beyond. The concept of personalized learning, the integration of technology in study activities, and the reform of leadership from the traditional, routine-oriented style into the more open, adaptive one are the critical issues of the research currently being conducted. These changes referring to personal learning differences, lifelong learning, and collaborative environment are meant to make them more evolved or advanced. Through the analysis, teachers being purely instructors changed to facilitators of learning, cultural responsiveness to teaching was emphasized, and the impossibility of attaining good outcomes without digitalization was brought into view. On the other hand, transformational leadership is especially relevant for change management with respect to community participation and data-based decision-making. This view of all angles on the future shows how the education systems that tend to be more flexible and diverse, as well as the ones that are better suited to meet all the diverse learning needs of all students, are the ones to thrive in this new global paradigm.

Strategic approaches in disaster management: Analyzing the roles of public health professionals from emergency response to post-disaster recovery

Disaster management presents a global challenge requiring the coordinated efforts of various sectors, especially public health professionals. The COVID-19 pandemic, declared by WHO in March 2020, marked a paradigm shift in disaster management and public health responses. This study examines the role of public health professionals during different disaster management phases, with a focus on Indonesia and global examples. Findings from Siti Marlina et al. (2022) and O. Olu (2017) highlight the critical role of community health centers and resilient health systems. The research also explores the Lombok earthquake response (Xu et al., 2018; Skinner, 2018; Kunugita et al., 2018; Brun &amp; Pakenham-Walsh, 2018) and the broader implications of disaster management trends in Spain (Arcos González et al., 2023) and nuclear event concerns (Dallas, 2022). The study underscores the importance of mental health support (Peppou et al., 2021; Raesi et al., 2020) and offers recommendations for improving disaster management, including enhancing training, integrating public health into planning, and leveraging technology.

Management of Innovation in Digital Brands: An Integrative Review

The present paper explores how innovation management is manifested in digital brands. The objective of this study is to analyze the approaches to innovation management within digital brands. The methodology adopted is an integrative review with a qualitative approach. Innovation management in digital brands has become increasingly crucial in today's dynamic business landscape. Digitalization has revolutionized the way brands interact with consumers, requiring constant innovation to remain competitive. This study aims to shed light on the strategies and practices adopted by digital brands to manage innovation effectively. The methodology has a qualitative approach through integrative review, which allows for the synthesis of existing literature on innovation management in digital brands. Through research and analysis of academic articles, this article identifies key themes and trends in innovation management in the digital context. Themes such as open innovation, co-creation with consumers, agile development methodologies, and digital transformation strategies emerge as central components of innovation management in digital brands. A conceptual framework is developed to provide a structured understanding of the various dimensions of innovation management in digital brands. This framework serves as a guide for professionals and researchers seeking to navigate the complex landscape of innovation in the digital age. The results of this study reveal a multifaceted approach to innovation management in digital brands. Also it includes the development of a descriptive figure conceptual of innovation management in digital brands. In conclusion, this integrative review highlights the importance of effective innovation management in digital brands. By adopting innovative strategies and embracing digital technologies, brands can drive growth, improve customer experiences, and maintain competitiveness in today's digital economy. Furthermore, this study contributes to the academic discourse by offering insights into the evolving nature of innovation management in the digital sphere. By understanding these dynamics, organizations can adapt their strategies to thrive in an increasingly digital-centric marketplace.

Trends in Management of Rhesus Alloimmunization Over Two Decades From a Tertiary Care Referral Center in India

Trends in Management of Rhesus Alloimmunization Over Two Decades From a Tertiary Care Referral Center in India

Exploring Trends in Sports Event Research (2014–2023): A Bibliometric Analysis

This study provides a comprehensive bibliometric analysis of sports event research from 2014 to 2023, using data from the Web of Science database. The research examines key trends, influential publications, prolific authors, and prevailing themes in the field. This study identifies the core areas of focus and emerging trends in sports event management, sustainability, and economic impacts through a detailed analysis of citations, co-authorship networks, and keyword co-occurrence. The results offer insights for researchers and practitioners interested in advancing knowledge in sports event planning, management, and legacy.

Trends in orbital cellulitis severity and management: 2016 through 2022

ABSTRACT Purpose To characterize trends in orbital cellulitis (OC) severity and management from 2016 through 2022, including assessment of effects from the COVID-19 pandemic. Methods A retrospective chart review was conducted at a tertiary care center using an electronic medical record search of OC from January 1 2016 to January 1 2023. Radiography was used to categorize patients into three cohorts – OC without abscess, OC with subperiosteal abscess (SPA), and OC with orbital abscess (OA). Infection cohort and age group [pediatric (<9 years old), adolescent (9–18 years), adult (>18 years)] were compared across years. Subgroup analysis was performed in the SPA cohort. Comparisons were made between the time periods prior to and after the start of the COVID-19 pandemic. Results From 2016–2022, there were 247 (67.3%) cases of OC, 103 (28.1%) SPA, and 17 (4.6%) OA. The year 2022 incurred higher rates of SPA and OA (p = 0.035), pediatric infections (p = 0.008), and co-morbid sinusitis (p = 0.005) compared to all preceding years. Rates were similar from 2016 through 2021. Within the SPA cohort, rates of surgical intervention and outcomes were similar across all years. Rate of abscess formation was significantly higher during the COVID-19 pandemic compared to the pre-pandemic era (p = 0.033). Conclusion The severity of OC leading up to the COVID-19 pandemic appeared steady. After pandemic onset, a delayed increase in abscess formation, predominantly affecting pediatric patients and correlating with a greater rate of sinusitis, was observed in 2022.

Management of Syndesmotic Ankle Injuries: Results of a Survey of Pediatric Orthopaedic Society of North America Members

BackgroundAlthough utilization of dynamic suture-button fixation for adult syndesmotic injuries has shown improved outcomes over static screw fixation, data in pediatric populations is limited. This study evaluated trends in management and identified factors influencing surgeon choice of implant for pediatric syndesmotic injuries. MethodsThe Pediatric Orthopaedic Society of North America (POSNA) members were surveyed regarding syndesmotic injury implant preferences between October 2021 and May 2022. Respondents that opted out, treated <1 syndesmotic ankle injury in the past year, or had conflicting financial obligations were excluded. Results were summarized and analyzed using logistic regression to assess for significance between years posttraining and technique preference. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for significance (P-values<.05). ResultsAmong 103 respondents to the survey (with 102 complete responses), 25% were <5 years posttraining, 24% between 5 and 10 years, 21% between 11 and 15 years, and 28% ​> ​15 years posttraining. Twenty-four percent (24/102) preferred screw versus 76% (78/102) preferring suture-button implants for syndesmotic injuries. Members >15 years posttraining were 4.7 times more likely to prefer screw implants compared to members <5 years posttraining (OR ​= ​4.7; 95% CI, 1.14–19.34; P ​= ​.03). Since starting their clinical practice, 62 respondents (60%) reported an implant preference change, with avoidance of secondary surgery (46/62; 74%) and extrapolation from adult outcomes (39/62; 63%) cited as primary motivating factors. Of the 40 members with no preference change, comfort with the procedure was the primary cited reason (33/40; 83%). Among those choosing operative intervention, radiograph-based cases showed preference for the suture-button in 70%–79% of respondents for skeletally mature patients versus 71%–81% for skeletally immature patients. ConclusionsOur data shows that the shift over time from screw to suture-button implant fixation for pediatric and adolescent syndesmotic ankle injuries is largely due to interest in avoiding implant removal and extrapolation from superior outcomes seen with suture-button use in adults. Larger comparative studies of pediatric and adolescent patients treated with suture-button versus screw fixation are needed to establish standards of care for these challenging injuries. Key Concepts(1)Literature for operative syndesmotic injury management in adults has shown improved outcomes of dynamic suture-button fixation over static screw fixation, but data in pediatric and adolescent populations is limited.(2)A survey of 102 POSNA members shows that 76% prefer suture-button, 24% prefer screw fixation with members >15 years posttraining 4.7 times more likely to prefer screw fixation to members <5 years posttraining.(3)Among 62 respondents who switched implant preference during their clinical practice, avoidance of secondary surgery and extrapolation from outcomes in adults were the two most cited reasons.(4)Among 40 respondents who did not switch implant preference, comfort with the procedure was the most cited reason.(5)Comparative studies of suture-button versus screw implants for treatment of pediatric and adolescent syndesmotic ankle injuries are needed to establish an evidence-based standard of care management. Level of EvidenceLevel V: Expert Opinion