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Background: Simulation-based training is one way to improve basic competence for surgical trainees and thus improve patient safety. Closed reduction and percutaneous pinning of a supracondylar humerus fracture is a common procedure that encompasses many basic orthopaedic skills and has been identified as a residency milestone. Despite this, no quantitative tools exist to help learners attain this basic skill. This study seeks to validate a quantitative, low-cost simulation-based training tool for teaching orthopaedic surgery trainees the fundamentals of fracture stabilization with pins.
Methods: Two low-cost models were developed with simulated cancellous bone blocks and cortical bone sheets: a pinning agility tool to teach pin placement and redirection, and a low-cost construct stability tool to replicate pinning. A high-cost construct stability tool was cut using a pediatric supracondylar humerus model to simulate pinning a real fracture. Construct stability was assessed by adding weight until ∼1.6 mm of displacement was observed. Participants were tested naively on all 3 models and then completed a training session using only the low-cost models. Performance following training was then assessed and compared with fellowship-trained pediatric orthopaedic surgeons. Participants also rated their preintervention and postintervention confidence, skill, and knowledgeability.
Results: A total of 18 novice trainees participated (10 PGY1 and PGY2 orthopaedic surgery residents and 8 medical student members of the orthopaedic surgery interest club), whereas the reference group consisted of 7 orthopaedic surgery attendings. The subjects significantly improved their scores on both the low-cost (P=0.002) and high-cost (P<0.001) construct stability tools after the training with only the low-cost tools. Compared with the attending benchmark, trainee scores improved on the high-fidelity model from 31% preintervention to 86% postintervention and their pinning times decreased by 38%. Trainees reported increased knowledge, skill, and confidence after the intervention (P<0.001).
Conclusions: A novel, low-cost simulation model and training session for supracondylar humerus fracture pinning resulted in improved performance in stabilizing a supracondylar humerus model and increased trainee knowledgeability, confidence, and skill.
Level Of Evidence: Level II-economic.
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http://dx.doi.org/10.1097/BPO.0000000000001460 | DOI Listing |
J Cell Mol Med
December 2024
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Macrophage efferocytosis (clearance of apoptotic cells) is crucial for tissue homeostasis and wound repair, where macrophages secrete factors that promote resolution of inflammation and regenerative signalling. This study examined the role of efferocytic macrophage-associated CCL2 secretion, its influence on mesenchymal stem/progenitor cell (MSPC) chemotaxis, and in vivo cell recruitment using Ccr2 (KO) mice with disrupted CCL2 receptor signalling in two regenerative models: ossicle implants and ulnar stress fractures. Single cell RNA sequencing and PCR validation indicated that efferocytosis of various apoptotic cells at bone injury sites (osteoblasts, pre-osteoblasts, MSPC) upregulated CCL2.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
December 2024
Sporthopaedicum, Berlin, Germany.
Purpose: Sulcus-deepening trochleoplasty (TP) effectively treats patellofemoral (PF) instability (PFI) caused by high-grade trochlear dysplasia (TD), but current evidence is based on small case series. We hypothesised, that TP would result in significant functional improvements and a low re-dislocation rate but would not accelerate the progression of PF cartilage deterioration.
Methods: We retrospectively reviewed all TP cases performed by a single surgeon between 2015 and 2021.
Knee Surg Sports Traumatol Arthrosc
December 2024
Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, Brandenburg an der Havel, Germany.
The evolution of orthopaedics has witnessed a pronounced shift from generalist practice to subspecialisation, a trend that has fundamentally reshaped the field over the past century. Originally, orthopaedic surgeons were trained to address a broad spectrum of musculoskeletal conditions. However, increasing complexity and specialization in knowledge have driven a progressive narrowing of focus within orthopaedics.
View Article and Find Full Text PDFOchsner J
January 2024
Department of Orthopedics, University of New Mexico School of Medicine, Albuquerque, NM.
Complete talar extrusion is a rare injury that is typically caused by high-energy impact. Treatment for a completely extruded talus is limited and has variable outcomes and complications. Tibiocalcaneal arthrodesis is one of the best treatments for restoring stability and reducing pain in the affected limb.
View Article and Find Full Text PDFCureus
December 2024
Department of Trauma and Orthopaedic Surgery, Our Lady of Lourdes Hospital Drogheda, Royal College of Surgeons in Ireland (RCSI) Hospital Group, Drogheda, IRL.
Introduction: Trauma and orthopedics departments have traditionally used face-to-face (FTF) fracture clinics for non-operative fractures. Developed in 2011, the virtual fracture clinic (VFC) was fully implemented at an institution during the COVID-19 pandemic to reduce in-person interactions.
Aims: First, the study aims to measure the percentage of non-operative patients triaged through the VFC when this was optional and re-audit after implementing a COVID-19-related policy change mandating VFC triage.
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