Bridging Ergonomic Awareness and Practice in Cleft Surgery: Insights From An International Craniofacial Cleft
Amal Halwani1,2, Tamara Rodriguez1,2, Dana Andari1,2
1Global Smile Foundation, Norwood, MA, USA.
Abstract:
ObjectiveTo determine the prevalence and anatomical distribution of work-related musculoskeletal disorders (WRMDs) among cleft surgeons and evaluate associations with ergonomic practices, training exposure, and physical activity patterns.DesignCross-sectional survey study.SettingAn International Craniofacial Cleft Workshop.ParticipantsCleft surgeons attending the workshop either in person or virtually.InterventionsNone. A 25-item anonymous questionnaire assessing musculoskeletal symptoms, ergonomic behaviors, and physical activity habits was administered.Main Outcome MeasuresPrevalence and anatomical distribution of self-reported musculoskeletal discomfort among participating cleft surgeons across predefined anatomical regions. Extensive musculoskeletal involvement was defined as symptoms affecting three or more anatomical regions. Associations between ergonomic behaviors, prior ergonomic training, physical activity patterns, and musculoskeletal burden were analyzed to identify potential contributing and protective factors.ResultsA total of 108 surgeons responded to the survey. Musculoskeletal discomfort was highly prevalent, most commonly affecting the neck (68.5%), lower back (38.9%), and upper back (34.3%). Many respondents reported that symptoms interfered with leisure activities, concentration, or surgical performance. Although most surgeons indicated familiarity with surgical ergonomics, only 18.5% had received formal ergonomic training. Preventive intraoperative behaviors such as posture monitoring and micro-breaks were inconsistently practiced. Strength training was independently associated with lower odds of extensive musculoskeletal involvement (Odds ratio 0.61; 95% confidence interval 0.15-0.99).ConclusionsWRMDs are common among cleft surgeons, and ergonomic awareness does not consistently translate into preventive behaviors. Incorporating structured ergonomics education into surgical training and implementing standardized intraoperative preventive strategies may promote long-term musculoskeletal health and career sustainability in cleft practice.
