足部和踝关节手术是否存在学习曲线？
Is there a learning curve in foot and ankle surgery?
机构信息
Mersey Deanery, United Kingdom.
出版信息
Foot Ankle Surg. 2012 Mar;18(1):62-5. doi: 10.1016/j.fas.2011.03.007. Epub 2011 May 25.
BACKGROUND
Previous studies of orthopaedic learning curves have largely described the introduction of new techniques to experienced consultants. End points have usually involved technical considerations. A paucity of evidence surrounds foot and ankle surgery. This study investigates the learning curve during a foot and ankle surgeon's first year, defined by functional outcome.
METHODS
150 patients underwent elective foot or ankle surgery during the whole period. Preoperative and 6 month postoperative functional scores were compared between the first and second 6 month groups.
RESULTS
Functional improvement was greater, approaching significance, in the second group (p=0.0605). There was no difference for forefoot cases (p=0.345). Functional improvement was significantly greater in the second group with forefoot cases removed (p=0.0333).
CONCLUSIONS
A learning curve exists in the first year of practice of foot and ankle surgery, demonstrated by functional outcome. This is confined to ankle, hindfoot and midfoot, but not forefoot surgery.
背景
以往关于骨科学习曲线的研究主要描述了新技术在经验丰富的顾问中的引入。终点通常涉及技术考虑因素。足部和踝关节手术的证据很少。本研究通过功能结果来研究足踝外科医生第一年的学习曲线。
方法
在整个期间，有 150 名患者接受了择期足部或踝关节手术。比较了前 6 个月和后 6 个月两组患者的术前和术后 6 个月的功能评分。
结果
第二组的功能改善更大，接近显著（p=0.0605）。前足病例无差异（p=0.345）。去除前足病例后，第二组的功能改善显著更大（p=0.0333）。
结论
在足踝外科实践的第一年存在学习曲线，这可以通过功能结果来证明。这仅限于踝关节、后足和中足，而不是前足手术。
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