Is actual surgical experience reflected in virtual reality simulation surgery for a femoral neck fracture?

• Published in: European journal of orthopaedic surgery & traumatology 2019-10, Vol.29 (7), p.1429-1434
• Main Authors: Homma, Yasuhiro, Mogami, Atsuhiko, Baba, Tomonori, Naito, Kiyohito, Watari, Taiji, Obayashi, Osamu, Kaneko, Kazuo
• Format: Article
• Language: English
• Subjects: Bone Nails; Bone Plates; Clinical Competence; Femoral Neck Fractures - diagnostic imaging; Femoral Neck Fractures - surgery; Fluoroscopy; Fractures; Humans; Medicine; Medicine & Public Health; Operative Time; Original Article • HIP - FRACTURES; Simulation Training; Surgery; Surgical Orthopedics; Time Factors; Trauma; Traumatic Surgery; Traumatology - education; Virtual Reality
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-019-02465-9

Introduction A virtual reality simulator developed for orthopaedic and trauma surgical training has been introduced. However, it is unclear whether the experiences of actual surgery are reflected in virtual reality simulation surgery (VRSS) using a simulator. The aim of this study is to investigate whether the results in VRSS differ between a trauma expert and a trauma novice. Methods In Group A (expert), there are ten orthopaedic trauma surgeons and in Group B (novice) ten residents within 2 years after medical school graduation. VRSS for a femoral neck fracture using Hansson hook-pins (Test 1) and Hansson twin hook plate (Test 2) was performed. The parameters evaluated were total procedure time (s), fluoroscopy time (s), number of times X-ray was used (defined by the number of times the foot pedal was used), number of retries in guide placement, and final implant position. Results In Test 1, the averages of four parameters (distance to posterior cortex ( p  = 0.009), distal pin distance above lesser trochanter ( p  = 0.015), distal pin hook angular error ( p  = 0.004), and distal pin tip distance to centre (lateral) ( p  = 0.015)) were significantly different between Groups A and B. In Test 2, no parameters in a mean were significantly different between groups, but seven parameters in a variance (guide wire distance to joint surface ( p  = 0.0191), twin hook length outside barrel ( p  = 0.011), twin hook tip distance to centre (lateral) ( p  = 0.042), twin hook distance to centre of lateral cortex (lateral) ( p  = 0.016), plate end alignment error (lateral) ( p  = 0.027), guide wire angle with lateral cortex (front) ( p  = 0.024), and 3.2-mm drill outside cortex ( p  = 0.000)) were significantly different between groups. In Test 1, Group B showed significantly longer fluoroscopy time than Group A ( p  = 0.044). In Test 2, Group B showed significantly fewer instances of X-ray use than Group A ( p  = 0.046). Conclusions Our study showed that the experiences of actual surgery are reflected in the result of VRSS using the simulator.