Department of Orthopaedic Surgery, University of Virginia Health System, P.O. Box 800159, Charlottesville, VA 22908-0159, USA.
Int Orthop. 2011 Jan;35(1):113-9. doi: 10.1007/s00264-010-0950-7. Epub 2010 Feb 20.
The aim of this study was to identify and characterise learning curves in hip fracture surgery. Operating times were collected and related to the number of procedures done by residents performing closed reduction and internal fixation using cannulated screws for intracapsular fractures of the hip and cephalomedullary nailing for trochanteric fractures, as well as hemiarthroplasty for displaced intracapsular fractures. The mean operating times decreased significantly for all four procedures studied, though at different rates. For cannulated screws, the mean duration of surgery decreased from 47.8 minutes to 30.1 minutes for procedures 21-25. For cephalomedullary nailing without distal locking, the mean operating time decreased from 73.3 minutes to 36.3 minutes. For cephalomedullary nailing with distal locking, the mean operating time decreased from 81.7 minutes to 56.9 minutes. The mean operating time for hemiarthroplasty decreased from 97.3 minutes to 66.0 minutes. Mean operating times decreased significantly for all procedures studied, though at different rates, indicating a unique learning curve for each procedure.
本研究旨在确定和描述髋关节骨折手术的学习曲线。收集手术时间，并将其与接受过闭合复位和经皮螺钉内固定治疗髋关节囊内骨折、股骨近端髓内钉治疗转子间骨折以及人工半髋关节置换术的住院医师的手术次数相关联。尽管各手术的学习曲线下降速度不同，但所有 4 种手术的平均手术时间均显著下降。对于经皮螺钉内固定，第 21-25 次手术的平均手术时间从 47.8 分钟降至 30.1 分钟。对于不进行远端锁定的股骨近端髓内钉，平均手术时间从 73.3 分钟降至 36.3 分钟。对于进行远端锁定的股骨近端髓内钉，平均手术时间从 81.7 分钟降至 56.9 分钟。人工半髋关节置换术的平均手术时间从 97.3 分钟降至 66.0 分钟。尽管各手术的学习曲线下降速度不同，但所有手术的平均手术时间均显著下降，这表明每种手术都有其独特的学习曲线。
