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O ur current trajectory suggests we are so far behind the curve of bringing women into orthopaedics that it would take a century or so to balance the scales; the previous bastions of neurosurgery and urology are out in front on this issue [21, 28]. Nothing is more disheartening to me as a medical student adviser than to see a young woman, exuberant with the discovery of surgery and what it has to offer, choose a nonsurgical specialty. The reason? Lifestyle and culture, however perceived and ill-informed. This is, in my mind, an injustice to our specialty. Suffice it to say we have work to do. Recall the ‘‘glass ceiling.’’ Introduced almost four decades ago, the glass ceiling refers to the visible, but unattainable fruits of leadership to women and minorities in business and traditional white-collar professions [9, 10]. The purported reasons for economic and leadership disparity between men and women in the corporate world, orthopaedics, and society are manifold but similar: Lack of talent, lack of accessibility, lack of flexibility to meet high demands of said industry, and lack of negotiating and networking skills [3, 7, 8, 18, 26]. Similar to Fortune 500 companies, Wall Street, the sciences, medicine, and academia, the number of women executives and directors in Hollywood remain appallingly low [5–8, 13, 26]. The hierarchy of the motion picture industry—the business part of the fun—has enough similarities to the sciences and orthopaedics that it is worth a socioeconomic reflection. In Hollywood, storylines are hyperbolized, characters dramatized, and shoot-’em-up action and internal strife wrench guts and evoke tears. But to me, one of the more unsettling aspects of visual entertainment is that women are often portrayed as sidekicks, love interests, and accompliceswho—if they are too pretty, too strong, too much a vixen—either die or get their considerable punishment. I have often wondered, ‘‘Why are they so stupid, so helpless, or so fake?’’ The best andmost assertive among them—from Batgirl to Bond Girls—tend to get sidelined, bumped off or even worse, rescued by their male counterparts. Recent attention has identified the paucity of women in serious acting, directorial, or executive roles, affecting the movie industry at all levels. Note from the Editor-in-Chief: We are pleased to present to readers of Clinical Orthopaedics and Related Research the latest installment of ‘‘Gendered Innovations in Orthopaedic Science’’ by Amy L. Ladd MD. Dr. Ladd is a Professor in the Department of Orthopaedics at Stanford University. She provides commentary on sex and gender similarities and differences in orthopaedics. The author certifies that she, or any members of her immediate family, have no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of Clinical Orthopaedics and Related Research or The Association of Bone and Joint Surgeons. A. L. Ladd MD (&) Chase Hand and Upper Limb Center, Stanford University, 770 Welch Rd. Suite 400, Palo Alto, CA 94304-1801, USA e-mail: aladd@stanford.edu Gendered Innovations in Orthopaedic Science Published online: 17 March 2016 The Association of Bone and Joint Surgeons1 2016

Gendered Innovations in Orthopaedic Science: Hollywood and Orthopaedics: Through the Glass Ceiling—Darkly