Universität zu Köln

Wegmann, Kilian, Harbrecht, Andreas ORCID: 0000-0002-9951-7629, Hackl, Michael, Uschok, Stephan, Leschinger, Tim and Mueller, Lars P. (2020). Inducing life-like distal radius fractures in human cadaveric specimens: a tool for enhanced surgical training. Arch. Orthop. Trauma Surg., 140 (3). S. 425 - 433. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Introduction Surgical education consists often times of a discrepancy between necessary amount of provided operative teaching and amount of organizational and ward duties. Operative education is often cut to a minimum. As public awareness toward surgical competence raises, so must the educational system. Courses that provide pre-fractured cadaveric specimens can facilitate surgical teaching realistically, prior to operating on living patients. The aim of this study is to introduce a realistic distal radius fracture simulation setup. Materials and methods 12 cadaveric specimens (3 male, 9 female) were fixed onto a custom drop-test-bench in the hyperextension of the wrist. The forearm was cut midway between elbow and carpus. The distal part of the forearm was potted, and the specimen was exposed to a high energetic impulse. CT imaging was performed after fracture simulation to detect the exact fracture patterns. We used the AO/ASIF recommendations and four-corner concept to classify the achieved fractures by two independent trauma surgeons. Results All cadaveric specimens could be successfully fractured. 11 fractures were classified as type 23C3.2 and one was classified as type 23C3.3, as additional fracture of diaphysis occurred. Subclassification according to the four-corner concept showed all fractures to be type C. A concomitant ulnar styloid fracture was observed in 4 cases. Furthermore, all cases showed at least one fragment involving the sigmoid notch. There was no statistically significant correlation found regarding Hounsfield Units (HU) and age (p value 0.402), as well as HU and required kinetic energy (p value 0.063). Conclusion A high energetic impulse induced by a custom-made drop-test bench can successfully simulate realistic distal radius fractures in cadaveric specimens with intact soft tissue. Furthermore, these pre-fractured specimens can be utilized in surgical education to provide a teaching experience as realistic as possible without harming living patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbrecht, Andreas UNSPECIFIED orcid.org/0000-0002-9951-7629 UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Uschok, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-124751
DOI:	10.1007/s00402-019-03313-5
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	140
Number:	3
Page Range:	S. 425 - 433
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VOLAR LOCKING PLATE; SKILLS; EPIDEMIOLOGY; SIMULATION; SURGERY; TRAUMA; MODELS; IMPACT; CT Multiple languages Orthopedics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12475