Lazarus P, Pire E, Sapa C, Ruffenach L, Saur M, Liverneaux P, Hidalgo Diaz J J
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
Hand Surg Rehabil. 2017 Sep;36(4):275-280. doi: 10.1016/j.hansur.2017.03.002. Epub 2017 Apr 11.
Legislation concerning workload of surgical trainees and pressure to reduce learning curves have forced us reconsider surgical training. Our goal was to evaluate a synthetic procedural simulator for teaching open reduction and internal fixation (ORIF) of distal radius fractures (DRF). Twenty surgeons used a synthetic procedural simulator (Wristsim) made by 3D printing for ORIF of DRF with a volar plate (Newclip Technics). The evaluation consisted of grading the simulator's realism compared to the surgeons' own experience with surgery on cadavers. The Wristsim was graded 5.10/10, compared to 8.18/10 for the cadaver specimen for introduction of the plate under pronator quadratus. For fracture reproduction, Wristsim scored 6.40/10, with the cadaver specimen scoring 7.15/10. For fracture reduction, Wristsim scored 5.62/10, with the cadaver specimen scoring 7.38/10. Plate application was scored 7.05/10 for Wristsim and 8.23/10 for the cadaver. Drilling was scored 6.60/10 for the Wristsim and 8.23/10 for the cadaver. Screw fixation was scored 7.40/10 for the Wristsim and 8.12/10 for the cadaver. Our results demonstrated that Wristsim is still inferior to a cadaver specimen for teaching ORIF by volar plating of DRF. A new model of Wristsim is being developed that will address shortcomings in pronator quadratus thickness, passive ROM in flexion/extension and bone size.
有关外科住院医师工作量的立法以及缩短学习曲线的压力促使我们重新审视外科培训。我们的目标是评估一种用于教授桡骨远端骨折（DRF）切开复位内固定术（ORIF）的合成手术模拟器。20名外科医生使用了一种通过3D打印制作的合成手术模拟器（Wristsim），用于采用掌侧钢板（Newclip Technics）对DRF进行ORIF。评估内容包括将模拟器的逼真度与外科医生自身在尸体上进行手术的经验相比较并打分。在旋前方肌下置入钢板方面，Wristsim的评分为5.10/10，而尸体标本的评分为8.18/10。在骨折再现方面，Wristsim的得分为6.40/10，尸体标本的得分为7.15/10。在骨折复位方面，Wristsim的得分为5.62/10，尸体标本的得分为7.38/10。钢板置入方面，Wristsim的评分为7.05/10，尸体标本的评分为8.23/10。钻孔方面，Wristsim的评分为6.60/10，尸体标本的评分为8.23/10。螺钉固定方面，Wristsim的评分为7.40/10，尸体标本的评分为8.12/10。我们的结果表明，在通过掌侧钢板固定DRF来教授ORIF方面，Wristsim仍不如尸体标本。一种新的Wristsim模型正在开发中，它将解决旋前方肌厚度、屈伸被动活动度和骨骼尺寸方面的不足。
