Teaching Cortical-Screw Tightening: A Simple, Affordable, Torque-Directed Training Protocol Improves Resident...

Area of Science:

• Orthopaedic Surgery
• Surgical Skills Training
• Biomedical Engineering

Background:

• Cortical-screw insertion is a critical orthopaedic surgery skill.
• No standardized training method currently exists for this procedure.
• This study aimed to evaluate a novel training protocol for cortical screw insertion.

Purpose of the Study:

• To assess the efficacy of a torque-feedback training protocol for cortical screw insertion.
• To determine if the training improves screw placement accuracy and reduces stripping.
• To evaluate the impact of the training on residents and attending surgeons.

Main Methods:

• Twenty-five residents and 8 attending surgeons used a synthetic bone model and digital torque screwdriver.
• Three insertion techniques were tested: percutaneous, open dominant hand, and open non-dominant hand.
• Residents underwent training with real-time torque feedback, targeting 50-70% of stripping torque.

Main Results:

• Post-training, all residents showed reduced insertional torque.
• Senior residents improved screw placement within the target range and reduced stripping.
• Attending surgeons initially outperformed residents, but differences diminished over time.

Conclusions:

• The torque-directed training protocol enhanced skill acquisition for senior residents.
• Junior residents did not demonstrate significant improvement, suggesting varied learning curves.
• Further research is needed to confirm clinical skill transfer and refine the protocol.