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Introduction: Orthopaedic surgeons (OS) often face ergonomically demanding conditions, involving prolonged static and awkward postures, and repetitive tasks. These contribute significantly to the development of work-related musculoskeletal disorders (WRMSDs). Previous studies highlight a high prevalence of WRMSDs among OS, especially in the low back (68.42%), neck (56.14%), shoulder (42.1%), and upper back (31.57%). Static or awkward postures were cited by 84.2% as the primary factor for low back and neck issues (Sharan D, 2018). This highlights the need for deeper ergonomic assessments and preventive interventions. A Pediatric Orthopedic Surgery Team (POST) performing Single Event Multi-Level Surgeries (SEMLS) for children with Cerebral Palsy (CP), and procedures like posteromedial soft tissue release along with the Steindler procedure for clubfoot, reported a high incidence of WRMSDs. Traditional ergonomic tools often overlook the variability of posture and exposure duration, which are key contributors to WRMSD risk. This study aimed to assess WRMSD risks using the Time-based Assessment Computerised Strategy (TACOS) tool.

Methods: A prospective experimental study was conducted in a pediatric rehabilitation hospital. Three surgeries were included: two SEMLS for CP and one combined posteromedial soft tissue release with the Steindler procedure for clubfoot. The POST (n = 10) included a Chief Pediatric Orthopedic Surgeon, Assistant Surgeon, Scrub Nurse, Circulating Nurse, X-ray Technician, and OT Assistant. The TACOS tool was used to assess ergonomic risks via video analysis of intraoperative tasks. Surgeries lasted between 2–4 hours without intraoperative breaks.

Results: All members of the POST team (n=10) were found to be at high risk for spinal strain in the standing position. The predominant high-risk posture was identified as “standing with slight lumbar spine flexion.” The high-risk job tasks varied by role. The Chief Pediatric Orthopedic Surgeon frequently performed tasks involving a seated, unsupported position with trunk twisting. The Assistant Surgeons primarily exhibited standing posture with slight lumbar spine flexion. The Scrub Nurse also maintained a standing posture with slight forward bending. The X-ray Technician, responsible for controlling the C-Arm, often assumed a back extension posture with upper limbs elevated above head height.

Discussion: The study findings highlight the significant ergonomic risks faced by pediatric orthopedic surgical staff, particularly from sustained awkward postures and task-specific exposures. Variations in posture across roles underline the need for customized ergonomic interventions. Long surgical durations without breaks, coupled with static postures, likely exacerbate musculoskeletal strain. Preventive strategies including posture training, work-rest cycles, and ergonomic aids may help mitigate WRMSD risks in such high-demand environments.

Conclusion: Members of POST are exposed to a high risk of WRMSD. Appropriate handling techniques and postural advice must be emphasised to the POST.