RESUMO
OBJECTIVE: To determine if preoperative examination of patient additive manufactured (AM) fracture models can be used to improve resident operative competency and patient outcomes. DESIGN: Prospective cohort study. Seventeen matched pairs of fracture fixation surgeries (for a total of 34 surgeries) were performed. Residents first performed a set of baseline surgeries (nâ¯=â¯17) without AM fracture models. The residents then performed a second set of surgeries randomly assigned to include an AM model (nâ¯=â¯11) or to omit it (nâ¯=â¯6). Following each surgery, the attending surgeon evaluated the resident using an Ottawa Surgical Competency Operating Room Evaluation (O-Score). The authors also recorded clinical outcomes including operative time, blood loss, fluoroscopy duration, and patient reported outcome measurement information system (PROMIS) scores of pain and function at 6 months. SETTING: Single-center academic level one trauma center. PARTICIPANTS: Twelve orthopaedic residents, between postgraduate year (PGY) 2 and 5, participated in this study. RESULTS: Residents significantly improved their O-Scores between the first and second surgery when they trained with AM models for the second surgery (pâ¯=â¯0.004, 2.43 ± 0.79 versus 3.73 ± 0.64). Similar improvements were not observed in the control group (pâ¯=â¯0.916, 2.69 ± 0.69 versus 2.77 ± 0.36). AM model training also significantly improved clinical outcomes, including surgery time (pâ¯=â¯0.006), fluoroscopy exposure time (pâ¯=â¯0.002), and patient reported functional outcomes (pâ¯=â¯0.0006). CONCLUSIONS: Conclusions: Training with AM fracture models improves the performance of orthopaedic surgery residents during fracture surgery.