Digitally enhanced hands-on surgical training (DEHST) enhances the performance during freehand nail distal interlocking

• Published in: Archives of orthopaedic and trauma surgery 2024-04, Vol.144 (4), p.1611-1619
• Main Authors: Pastor, Torsten, Cattaneo, Emanuele, Pastor, Tatjana, Gueorguiev, Boyko, Beeres, Frank J. P., Link, Björn-Christian, Windolf, Markus, Buschbaum, Jan
• Format: Article
• Language: English
• Subjects: Bone Nails; Fracture Fixation, Intramedullary; Humans; Medicine; Medicine & Public Health; Orthopedics; Radiography; Tibia; Tibial Fractures - surgery; Trauma Surgery; X-rays
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-024-05208-6

Purpose Freehand distal interlocking of intramedullary nails remains a challenging task. Recently, a new training device for digitally enhanced hands-on surgical training (DEHST) was introduced, potentially improving surgical skills needed for distal interlocking. Aim To evaluate whether training with DEHST enhances the performance of novices (first-year residents without surgical experience in freehand distal nail interlocking). Methods Twenty novices were randomly assigned to two groups and performed distal interlocking of a tibia nail in mock operation under operation-room-like conditions. Participants in Group 1 were trained with DEHST (five distal interlocking attempts, 1 h of training), while those in Group 2 did not receive training. Time, number of X-rays shots, hole roundness in the X-rays projection and hit rates were compared between the groups. Results Time to complete the task [414.7 s (range 290–615)] and X-rays exposure [17.8 µGcm 2 (range 9.8–26.4)] were significantly lower in Group 1 compared to Group 2 [623.4 s (range 339–1215), p  = 0.041 and 32.6 µGcm 2 (range 16.1–55.3), p  = 0.003]. Hole projections were significantly rounder in Group 1 [95.0% (range 91.1–98.0) vs. 80.8% (range 70.1–88.9), p