Der Unfallchirurg
-
Arthroscopy is a technically challenging surgical procedure with a relatively shallow learning curve compared to open procedures. To become an expert special cognitive and manual abilities have to be acquired and trained. The current situation in further medical education combined with the increasing economic pressure in the medical field does not leave enough room for a time-consuming training in arthroscopic techniques. ⋯ An essential advantage of simulation training is the assessment of objective measurement parameters during the individual exercises. These parameters can be used to evaluate the learning process and performance of arthroscopic tasks. The aim of this review is to reflect the current state of simulation technology in arthroscopy and to show how simulator training can be meaningfully and effectively integrated into arthroscopic further training, exemplified by a modern medical further education concept.
-
Ankle fractures have many short and long-term consequences for patients. For this reason, psychosocial factors also play a role in the success of the treatment in addition to the surgical treatment. ⋯ In addition, an overview of the empirical data with respect to psychological influences and outcome factors in lower extremity fractures, specifically ankle fractures, is given. The current research indicates that psychosocial factors have a decisive influence on the physical and psychological outcome.
-
Review
[Human patient simulators for training in emergency surgery : Needs, status quo and potential].
Surgical providers must maintain currency and competency for low-volume high-risk procedures for optimal outcomes. There are currently a number of methods available to train for these rare but vital skills, ranging from simple to complex and inexpensive to expensive. Traditionally, these skills have been taught using human cadaveric and animal models, which are limited by availability (cadavers) and social acceptability (animals). ⋯ Partially perfused human cadavers have recently been shown to be an important adjunct to established trauma training. Human patient simulators (HPS) and the associated technology is rapidly expanding, but currently lack consistent realism to be used for competence training, when compared to traditional models and are currently cost-prohibitive. It will be important for surgical trainers and trainees to remain engaged and facilitate the development of realistic cost-effective training tools.
-
Fragility fractures of the pelvis are increasing in frequency. In most cases patients suffer a minor injury, have intense pain in the pelvic region and impaired mobility. The new fragility fractures of the pelvis (FFP) classification distinguishes between four types with increasing instability. ⋯ Alternative techniques for dorsal stabilization are iliosacral screw and transsacral bar osteosynthesis, transiliac internal fixator and lumbopelvic fixation. External fixation, retrograde transpubic screw fixation, anterior internal fixation and plate and screw osteosynthesis are alternatives for the anterior pelvic ring. Treatment of fragility fractures of the pelvis should be carried out as part of an orthogeriatric co-management.
-
The current reduction in working hours and the worldwide attempt to guarantee patient safety have led to significant changes in the training of surgical assistants. Numerous studies meanwhile present arthroscopic virtual reality (VR) simulators as very efficient tools for resident training. ⋯ Even though evidence that the acquired skills can be validly transferred to the operating theater is still needed, especially for arthroscopy, simulation has already become an indispensable form of further training.