Li A-Bing, Zhang Wei-Jiang, Wang Ji-Qi, Zhao You-Ming, Guo Wei-Jun
Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 Xue Yuan Xi Road, Wenzhou, Zhejiang 325000, China.
Biomed Res Int. 2017;2017:6781070. doi: 10.1155/2017/6781070. Epub 2017 Apr 19.
. The purpose of this study is to evaluate the learning curve of performing surgery with the InterTan intramedullary nail in treating femoral intertrochanteric fractures, to provide valuable information and experience for surgeons who decide to learn a new procedure. . We retrospectively analyzed data from 53 patients who underwent surgery using an InterTan intramedullary nail at our hospital between July 2012 and September 2015. The negative exponential curve-fit regression analysis was used to evaluate the learning curve. According to 90% learning milestone, patients were divided into two group, and the outcomes were compared. . The mean operative time was 69.28 (95% CI 64.57 to 74.00) minutes; with the accumulation of surgical experience, the operation time was gradually decreased. 90% of the potential improvement was expected after 18 cases. In terms of operative time, intraoperative blood loss, hospital stay, and Harris hip score significant differences were found between two groups ( = 0.009, = 0.000, = 0.030, and = 0.002, resp.). Partial weight bearing time, fracture union time, tip apex distance, and the number of blood transfusions and complications were similar between two groups ( > 0.5). . This study demonstrated that the learning curve of performing surgery with the InterTan intramedullary nail is acceptable and 90% of the expert's proficiency level is achieved at around 18 cases.
本研究的目的是评估使用InterTan髓内钉治疗股骨转子间骨折的手术学习曲线,为决定学习新手术的外科医生提供有价值的信息和经验。我们回顾性分析了2012年7月至2015年9月在我院使用InterTan髓内钉进行手术的53例患者的数据。采用负指数曲线拟合回归分析来评估学习曲线。根据90%学习里程碑,将患者分为两组,并比较结果。平均手术时间为69.28(95%CI 64.57至74.00)分钟;随着手术经验的积累,手术时间逐渐缩短。预计在18例手术后可实现90%的潜在改善。在手术时间、术中出血量、住院时间和Harris髋关节评分方面,两组之间存在显著差异(分别为=0.009、=0.000、=0.030和=0.002)。两组之间的部分负重时间、骨折愈合时间、尖顶距离、输血次数和并发症数量相似(>0.5)。本研究表明,使用InterTan髓内钉进行手术的学习曲线是可以接受的,在大约18例手术时可达到专家熟练水平的90%。