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.
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