High-Fidelity Simulation Training for Closed Reduction and Casting of Distal Radius Fractures

Abstract

Currently, the majority of distal radius reduction models use fractured synthetic bones, however, the lack of soft tissues lowers the fidelity of the simulation causing poor discriminative abilities between individuals of different experience levels. When soft tissues are incorporated into the model to increase haptic feedback, the outer shell of the model makes it difficult to accurately assess the adequacy of the reduction. Thus, while these models can provide biofeedback to develop a feel for the process of fracture reduction, they may not truly simulate the process of fracture reduction and casting. We thus sought to create a model that requires the learner to master all of the steps of the process to achieve a good final result. When combined with fluoroscopy, the simulation training with the fracture reduction model described here can recapitulate the entire process of distal radius fracture reduction and give the learner haptic and visual feedback on their reduction and casting performance in real-time. The exercise also helps them think through some of the logistical challenges that they are likely to face with real patients. This is the first distal radius fracture model to incorporate this objective feedback, allowing the participant to appreciate the effectiveness of their reduction and casting technique.