Utilising 3D-printed ex vivo biomimetics to improve open reduction and internal fixation (ORIF) simulation training for hand fractures

Abstract

Background: Surgery for hand trauma accounts for a significant proportion of the plastic surgery training curriculum. The aim of this article is to create a standardised simulation training module for hand fracture fixation on open reduction and internal fixation (ORIF) techniques for residents in order to create a standardised hand-training framework that universally hones their skill and prepares them for their first encounter in a clinical setting. Methods: A step-ladder approach training using three-dimensional (3D)–printed ex vivo hand biomimetics was employed on a cohort of 15 plastic surgery residents (n = 15). Assessment of skills using a score system (global rating scale) was performed in the beginning and the end of the module by hand experts in our unit. Results: The overall average score of the cohort pre- and post-assessment were 22.08/50 (44.16%) and 41.54/50 (83.08%) respectively. Significant (p < 0.01) difference of improvement of skills was noted on all trainees. All trainees confirmed that the simulated models provided in this module were akin to the patient scenario and noted that it helped them improve their skills with regards to ORIF techniques including improvement of their understanding of the 3D bone topography. Conclusion: We demonstrate a standardised simulation training framework that employs 3D-printed ex vivo hand biomimetics proven to improve the skills of residents and which paves the way to more universal, standardised and validated training across hand surgery. This is, to our knowledge, the first standardised method of simulated training on such hand-surgical cases. Level of Evidence: Not ratable.