Evaluation of a 3D-Printed Model for Simulating Closed Reduction and Percutaneous Pinning of Unstable Distal Radius Fractures
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Introduction: We evaluated construct validity of a 3D-printed displaced, unstable distal radius fracture (DRF) model for closed reduction and percutaneous pinning (CRPP). We hypothesized that clinical DRF experience levels would correlate with performance metrics during model CRPP. Methods: Thirteen volunteers across a spectrum of DRF experience participated, including orthopaedic surgery residents and hand surgery specialists (fellows and attendings). Participants completed a survey assessing confidence and experience with DRF CRPP; watched a video demonstrating model CRPP and evaluation procedures; independently performed model CRPP with a single, power-driven Kirschner wire; and provided anonymous feedback on the model. An independent observer recorded each participant's Kirschner wire locations, degrees of final sagittal-plane DRF model tilt on fluoroscopy, number of fluoroscopic images, and procedural time. We grouped participants based on experience level for analyses. Results: Group 1 consisted of six nonspecialized orthopaedic surgery residents and group 2 consisted of seven hand surgery specialists (five fellows; two attendings). Group 1 had less baseline confidence and fewer prior DRF CRPPs. Group 2 performed markedly better than group 1 in all metrics, including Kirschner wire entry point and final trajectory; final sagittal plane tilt (7° vs. 20° dorsal,< 0.05); number of fluoroscopic images (19 vs. 43,< 0.05); and procedure time (2:37 vs. 6:01,< 0.05). All partic
Abstract
Introduction: We evaluated construct validity of a 3D-printed displaced, unstable distal radius fracture (DRF) model for closed reduction and percutaneous pinning (CRPP). We hypothesized that clinical DRF experience levels would correlate with performance metrics during model CRPP. Methods: Thirteen volunteers across a spectrum of DRF experience participated, including orthopaedic surgery residents and hand surgery specialists (fellows and attendings). Participants completed a survey assessing confidence and experience with DRF CRPP; watched a video demonstrating model CRPP and evaluation procedures; independently performed model CRPP with a single, power-driven Kirschner wire; and provided anonymous feedback on the model. An independent observer recorded each participant's Kirschner wire locations, degrees of final sagittal-plane DRF model tilt on fluoroscopy, number of fluoroscopic images, and procedural time. We grouped participants based on experience level for analyses. Results: Group 1 consisted of six nonspecialized orthopaedic surgery residents and group 2 consisted of seven hand surgery specialists (five fellows; two attendings). Group 1 had less baseline confidence and fewer prior DRF CRPPs. Group 2 performed markedly better than group 1 in all metrics, including Kirschner wire entry point and final trajectory; final sagittal plane tilt (7° vs. 20° dorsal,< 0.05); number of fluoroscopic images (19 vs. 43,< 0.05); and procedure time (2:37 vs. 6:01,< 0.05). All participants recommended the model for educational use. Discussion: Hand surgery attendings and fellows performed better than residents in all metrics for CRPP with our displaced, unstable DRF model, indicating appropriate construct validity. All participants recommended the model for procedural education.