• Arch Orthop Trauma Surg · Oct 2021

    Fractures around the hip: inducing life-like fractures as a basis for enhanced surgical training.

    • Andreas Harbrecht, Valentin Rausch, Kilian Wegmann, Michael Hackl, Stephan Uschok, Tim Leschinger, and Lars P Müller.
    • Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. andreas.harbrecht@uk-koeln.de.
    • Arch Orthop Trauma Surg. 2021 Oct 1; 141 (10): 1683-1690.

    IntroductionIn this study we investigated if realistic fracture patterns around the hip can be produced on human cadaveric specimens with intact soft tissue envelope. Possible applications of such fractured specimens would be in surgical training.Materials And Methods7 cadaveric specimens (2 male, 5 female, 2 formalin-fixed, 5 fresh-frozen) were fractured. 2 specimens were fractured on both femurs, 5 only on one side, resulting in 9 fractures total. 5 fractures were set in our custom-made drop-test bench, 2 fractures by inducing axial force using a hammer, and the remaining 2 fractures by a direct dorsal approach and a chisel. AO/OTA and Pauwels classification were used to classify the fractures on the specimens by two independent trauma surgeons.ResultsIn our drop-test bench, axial load with the femur adducted by 10° resulted in an intertrochanteric fracture (AO type A1.3), adducted by 20° resulted in a femoral neck fracture (Pauwels type III). Fracture induction using a hammer resulted in two intertrochanteric fractures (AO type A2.2 right, A3.3 left). The use of a chisel resulted in both cases in a femoral neck fracture. The acetabulum could be fractured multifragmentarily through use of a hemiprosthesis as a stamp.ConclusionA high energetic impulse induced by a custom-made drop-test bench can successfully simulate realistic proximal femur and acetabular fractures in cadaveric specimens with intact soft tissue. Furthermore, axial load using a hammer as well as using a chisel through a direct dorsal approach represent additional methods for fracture induction. These pre-fractured specimens can be utilized in surgical education to provide a realistic teaching experience for specialized trauma education courses.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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