Learning curves in simulator-based training for percutaneous pelvic fixation: comparison between surgeons with and...

Area of Science:

• Orthopedic Surgery
• Surgical Education
• Medical Simulation

Background:

• Percutaneous pelvic fixation is a complex surgical skill with a steep learning curve for orthopedic trainees.
• Limited exposure during traditional training hinders proficiency in pelvic radiographic views and fixation techniques.
• Simulation-based training offers a safe, reproducible environment to accelerate learning and optimize surgical education.

Purpose of the Study:

• To compare the learning curves of junior and senior surgeons in percutaneous pelvic fixation.
• To assess performance progression over multiple simulation training sessions.
• To evaluate the impact of simulator training on accuracy, efficiency, and radiation exposure.

Main Methods:

• Eight participants (4 junior residents, 4 senior trainees) underwent 6-8 simulation sessions focusing on iliosacral, anterior column, and supra-acetabular screw fixation.
• Key outcome measures included screw accuracy, cortical breaches, wire repositioning, operative time, and radiation exposure.
• A non-randomized prospective comparative study design was employed.

Main Results:

• Junior surgeons demonstrated significant reductions in operative time and radiation exposure for sacroiliac and LC2 screw fixation (p < 0.01).
• Accuracy improved markedly in juniors, especially for anterior column screw placement (38% to 94%).
• While seniors showed limited improvement, juniors achieved comparable final performance metrics, with rapid learning in the first four sessions.

Conclusions:

• Simulator-based training effectively enhances accuracy and efficiency in percutaneous pelvic fixation.
• Less experienced surgeons benefit most, rapidly improving technical skills to levels comparable to experienced surgeons.
• Simulation training is a valuable tool for early surgical education in pelvic trauma fixation.