Implementing three-dimensional printed pelvises with idealized acetabular fractures to improve resident education

The complex anatomy of the acetabulum makes preoperative planning a challenging topic in orthopedic education. Effectively interpreting plain radiographs of acetabular fractures is important for time-sensitive cases and remains an initial step for guiding downstream care. Modern implementations of 3D printing include physical reconstructions from CT scans but is not easily accessible. This study aims to evaluate the value of cost-effective generic 3D printed models to improve resident performance on classifying real patient acetabular fracture examples.

22 orthopaedic surgery residents (PGY 1-5) were selected as participants to classify acetabular fractures in the pre-test and post-test surveys. Participants classified 10 acetabulum fracture examples using only the five standard X-ray views in the pre-test survey, then had 3 min at each of 10 stations to review the 3D models and X-rays of acetabular fractures, and finally at the end completed a post-test survey. The total number of correct answers and average perceived confidence were calculated at the participant level for both pre-test and post-test.

Results showed significantly different total scores between PGY cohorts for both total score (p = 0.00729) and average confidence (p = 0.0034). Factorial ANOVA of total score against PGY and test type displayed a significant improvement in PGY test scores from pre-test to post-test (p = 0.0453), as well as a significant difference between each PGY year (p = 0.00418). Factorial ANOVA of average confidence against PGY and test type displayed no significant improvement from pre-test to post-test (0.372), however PGY cohorts were shown to be significantly different in their average confidence (0.00677).

•This study demonstrates the effectiveness of 3D printed pelvic models in improving orthopaedic residents' ability to correctly diagnose acetabular fractures, making them an important adjunct for resident education.•Diagnostic accuracy significantly improved, but confidence levels remained unchanged.