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Related Experiment Video

Updated: Apr 24, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Variability in the Orthopaedic Residency Trainee Trauma Surgical Experience.

Todd Phillips1, Benjamin Fiedler, Joshua T Morrow

  • 1From the Levy Shoulder to Hand Center at the Paley Orthopedic & Spine Institute, Boca Raton, FL (Dr. Phillips), and the Department of Orthopaedics, Baylor College of Medicine, Houston, TX (Dr. Fiedler, Mr. Morrow, Mr. Gugala, Dr. Harrington, and Dr. Dirschl).

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
|April 22, 2026
PubMed
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Advance Practice Provider Performance Is Noninferior to That of Residents, but Likely not Superior: Commentary on an article by Ambika Nair, BS, et al.: "Effectiveness of a Structured Training Program in Pediatric Distal Radial Fracture Reduction for Orthopaedic Advanced Practice Providers".

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Orthopaedic residents at a level 1 trauma center showed similar surgical experience in fracture fixation. However, institutional differences in proximal femur and ankle fracture case volumes were noted compared to multicenter studies.

Area of Science:

  • Orthopaedic Surgery
  • Trauma Care
  • Surgical Education

Background:

  • Variability in surgical experience among residents is a concern in orthopaedic trauma training.
  • Level 1 trauma centers aim to provide comprehensive fracture fixation experience.
  • Assessing resident case logs is crucial for evaluating training consistency.

Purpose of the Study:

  • To analyze fracture fixation case logs from residents at a level 1 trauma center.
  • To identify variability in surgical experiences within a single orthopaedic residency program.
  • To compare resident case experiences with broader epidemiologic data.

Main Methods:

  • Retrospective case series of fracture fixation cases from 2022-2024.
  • Analysis of resident case logs using Current Procedural Terminology (CPT) codes.

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Last Updated: Apr 24, 2026

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  • Classification of fractures by anatomic region using the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association system.
  • Comparison with a multicentered epidemiologic study for external validation.

    • Main Results:

    • A total of 4,616 fracture fixation cases were reviewed across 14 residents.
    • No significant difference in surgical experience across anatomic regions was found within the institution (P = 0.189).
    • Significant differences observed compared to multicenter data: fewer proximal femur fractures (P < 0.001) and more ankle fractures (P < 0.001).

    Conclusions:

    • Residents in this program demonstrated similar exposure to various fracture pathologies.
    • Potential regional or institutional factors may influence fracture location and volume.
    • Residents must actively pursue sufficient surgical volume for clinical competence in fracture fixation.