Binnie Charlotte, Nayab Yumna, Bano Christopher, Gundle Leo, Davidson Jerome
Plastic Surgery, St George's Hospital, London, GBR.
Trauma and Orthopaedics, Guy's and St Thomas' Trust, London, GBR.
Cureus. 2024 Dec 11;16(12):e75520. doi: 10.7759/cureus.75520. eCollection 2024 Dec.
Background and aim Synthetic composite bone models (reinforced solid foam) have become the standardised material used in practical orthopaedic education. However, with discussions regarding whether composite foam truly replicates human bone, there has been a drive to explore other available models. Three-dimensional (3D) printing has risen in both popularity and availability, providing a new option in the creation of anatomically accurate bone models. We designed a pilot study to assess whether a new formulation of synthetic bone provides the same tactile feedback that is essential for training purposes. Method Orthopaedic trainees of various grades across two London hospital trusts were invited to participate in a distal radius fixation workshop. As part of the workshop, trainees were asked to complete the following three tasks on the two different models: Kirschner-wire driving, pilot hole drilling and screw insertion. Participants were blinded in this trial and not informed which model was made via 3D printing or the conventional composite bone. Following completion, participants provided feedback on tactile feedback for each task on each model. Results Twenty-three orthopaedic trainees participated in the workshop, with overall majority agreement in all clinical skills that the 3D-printed model provided better tactile feedback. Three-dimensional models were rated superior in K-wire driving (mean score 7.39 vs 4.82; p<0.001) and pilot hole drilling (7.87 vs 4.96; p<0.001), with no significant difference in screw insertion. Qualitative feedback from testers noted a more anatomical representation of the 3D-printed bone, in addition to an overall better representation of the corticomedullary junction. Conclusion Overall, 3D printed models provide a new high-fidelity and sustainable option when seeking bone models for modern-day orthopaedic training. At present composite bone remains the standard for workshops. However, with the growing availability of 3D-printing models, and as supported by this study, they crucially provide the medium for future orthopaedic surgeons to learn and gain confidence.
背景与目的 合成复合骨模型（增强实心泡沫）已成为骨科实践教学中使用的标准化材料。然而，随着关于复合泡沫是否真的能复制人体骨骼的讨论，人们开始探索其他可用模型。三维（3D）打印在普及程度和可用性方面都有所提高，为创建解剖学精确的骨模型提供了新选择。我们设计了一项试点研究，以评估一种新型合成骨配方是否能提供训练所需的相同触觉反馈。
方法 邀请伦敦两家医院信托机构不同级别的骨科实习生参加桡骨远端固定工作坊。作为工作坊的一部分，要求实习生在两种不同模型上完成以下三项任务：克氏针打入、导孔钻孔和螺钉置入。在该试验中参与者不知情，未被告知哪个模型是通过3D打印制作的，哪个是传统复合骨模型。完成后，参与者就每个模型上每项任务的触觉反馈提供意见。
结果 23名骨科实习生参加了工作坊，在所有临床技能方面，总体上大多数人都认为3D打印模型提供了更好的触觉反馈。三维模型在克氏针打入（平均得分7.39对4.82；p<0.001）和导孔钻孔（7.87对4.96；p<0.001）方面被评为更优，在螺钉置入方面无显著差异。测试者的定性反馈指出，3D打印骨的解剖结构表现更优，此外皮质骨-髓质交界处的整体表现也更好。
结论 总体而言，在为现代骨科训练寻找骨模型时，3D打印模型提供了一种新 的高保真且可持续的选择。目前复合骨仍然是工作坊的标准。然而，随着3D打印模型的可用性不断提高，并且正如本研究所示，它们至关重要地为未来骨科医生提供了学习和获得信心的媒介。
