Orthopaedic surgical training: the role of continuous surveillance and x-ray analysis in a district general hospital
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Thomas Southorn & Matthew Porteous
- چاپ و سال / کشور: 2011
Description
Introduction Assessing orthopaedic trainees when they are operating unsupervised is difficult. Using post-operative x-rays is one possibility that has yet to be explored fully. Awareness that minimising tip–apex distance (TAD) when inserting a sliding hip screw reduces the risk of screw cut out is important for orthopaedic trainees. The advent of the Picture Archive and Communication System has made the accurate measurement of TAD from x-rays and image intensifier films much easier. This study was to determine whether TAD would be reduced if a surgeon knew that his performance was being continually monitored. Patients and methods Thirty-one consecutive cases of sliding hip screw insertion by a single group of surgeons were identified and the TAD measured. The mean TAD was 16.11 mm (8.87–25.47 mm). The same surgeons were then re-educated as to the importance of the TAD and informed that their results would be monitored and discussed. The next 34 consecutive cases were collected prospectively. Results The mean TAD in these cases was 13.83 mm (6.72– 21.51 mm). There was a significant difference between the TAD for the two groups using the two-tailed t test (p=0.034). There was one implant failure in the pre-re-education group and none in the post-re-education group. Conclusion These results suggest that awareness of surveillance improves surgical performance even if the importance of the variable being assessed is already known and so can be used to evaluate the progress of orthopaedic trainees.
Eur Orthop Traumatol (2011) 1:153–155 DOI 10.1007/s12570-011-0036-z Received: 13 June 2010 / Accepted: 31 January 2011 / Published online: 14 February 2011
