Use of 3D Printed Models in Resident Education for the Classification of Acetabulum Fractures

• Published in: Journal of surgical education 2018-11, Vol.75 (6), p.1679-1684
• Main Authors: Lim, Philip K., Stephenson, Graham S., Keown, Thomas W., Byrne, Connor, Lin, Charles C., Marecek, Geoffrey S., Scolaro, John A.
• Format: Article
• Language: English
• Subjects: Acetabular fractures; Acetabulum - diagnostic imaging; Acetabulum - injuries; Classification; Fractures, Bone - classification; Fractures, Bone - diagnostic imaging; Humans; Internship and Residency - methods; Models, Anatomic; Orthopedics - education; Pelvis; Practice-Based Learning and Improvement; Printing, Three-Dimensional; Three-dimensional; Tomography, X-Ray Computed
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2018.04.019

To determine if three-dimensional (3D) printed models can be used to improve acetabular fracture pattern recognition and be a valuable adjunct in orthopedic resident education. Fifteen randomized testing stations with each containing plain radiographs (XRs), two-dimensional computed tomography (CT) scans, or 3D model of an acetabular fracture. Two orthopedic residency programs based at Level 1 trauma centers. Forty-one orthopedic residents, PGY 1-5. Senior residents were superior to junior residents at correctly identifying the provided acetabular fracture pattern. Overall, use of CT scans or the 3D model improved fracture classification as compared to standard XRs, but there was no significant difference between use of the CT scans and 3D models. Subjective survey results indicated agreement among residents that 3D models were accurate representations of acetabular fractures and that models would be a desired educational modality. 3D models improved the accuracy of acetabular fracture identification compared to XR. In addition, trainees were able to use 3D models to obtain similar accuracy compared to CT scans despite not having previous exposure to the models. Interobserver agreement improved when comparing CT to 3D, but did not provide greater than a fair agreement indicating that fracture patterns were difficult to accurately classify even with the use of 3D models. Residents’ subjective responses indicated a positive experience with the use of 3D models. We conclude that the incorporation of 3D models could be an important adjunct to orthopedic residency education for the evaluation complex fracture patterns, but is not significantly superior to identification with CT scans.