Fractures around the hip: inducing life-like fractures as a basis for enhanced surgical training.

Autor: Harbrecht A; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. andreas.harbrecht@uk-koeln.de.; Department of Anatomy I, Medical Faculty, University of Cologne, Cologne, Germany. andreas.harbrecht@uk-koeln.de., Rausch V; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.; Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany., Wegmann K; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany., Hackl M; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany., Uschok S; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany., Leschinger T; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany., Müller LP; Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2021 Oct; Vol. 141 (10), pp. 1683-1690. Date of Electronic Publication: 2020 Oct 19.
DOI: 10.1007/s00402-020-03628-8
Abstrakt: Introduction: In this study we investigated if realistic fracture patterns around the hip can be produced on human cadaveric specimens with intact soft tissue envelope. Possible applications of such fractured specimens would be in surgical training.
Materials and Methods: 7 cadaveric specimens (2 male, 5 female, 2 formalin-fixed, 5 fresh-frozen) were fractured. 2 specimens were fractured on both femurs, 5 only on one side, resulting in 9 fractures total. 5 fractures were set in our custom-made drop-test bench, 2 fractures by inducing axial force using a hammer, and the remaining 2 fractures by a direct dorsal approach and a chisel. AO/OTA and Pauwels classification were used to classify the fractures on the specimens by two independent trauma surgeons.
Results: In our drop-test bench, axial load with the femur adducted by 10° resulted in an intertrochanteric fracture (AO type A1.3), adducted by 20° resulted in a femoral neck fracture (Pauwels type III). Fracture induction using a hammer resulted in two intertrochanteric fractures (AO type A2.2 right, A3.3 left). The use of a chisel resulted in both cases in a femoral neck fracture. The acetabulum could be fractured multifragmentarily through use of a hemiprosthesis as a stamp.
Conclusion: A high energetic impulse induced by a custom-made drop-test bench can successfully simulate realistic proximal femur and acetabular fractures in cadaveric specimens with intact soft tissue. Furthermore, axial load using a hammer as well as using a chisel through a direct dorsal approach represent additional methods for fracture induction. These pre-fractured specimens can be utilized in surgical education to provide a realistic teaching experience for specialized trauma education courses.
(© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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