Take the challenge: AO Trauma’s successful fracture challenge courses simulating real-life OR situations

Orthopedic trauma surgeons have a chance to take their fracture management skills to the next level at AO Trauma’s one-of-a-kind fracture challenge courses simulating real-life operating room (OR) situations. Across a range of fracture management topics—foot and ankle and wrist (distal radius/ulna and carpal bones)—the 2024 courses represent another step forward for the AO in its mission to promote excellence in patient care and outcomes in trauma and musculoskeletal disorders.

Taking place in March and June 2024 at the excellent facilities at CADLAB Cologne, Germany, these courses feature AO Trauma master surgeons using specimens with prefractured bone to simulate demanding and complex fractures.

“Prefractured anatomical specimens allow us to simulate reality as closely as possible, since participants will have to plan the treatment with the same imaging modalities at hand in the hospital,” Reto Babst explains. “Participants will perform surgery according to plan using the same approaches and encountering the same anatomical conditions as in reality, except for blood flow. Each participant will reduce the fracture, maintain the reduction, and fix the fracture, documenting each step, just as in real life.”

Real-life surgery simulation

In preoperative lab sessions, each three-person group of participants will receive a prefractured specimen along with identical X-rays, computed tomography (CT) scans, 3D computed tomography (CT) scans, and time to devise a preoperative plan. Each group will then take its plans into the simulated OR to treat the case according to plan. Each step of the process is to be documented with the help of C-arm fluoroscopic imaging and, at the end of the wet lab session, each group will present its case, using the fluoroscopic images and the fixed prefractured specimen.

A unique chance to learn from masters

“The participant gets hand-on simulation training by performing real surgery in a real, challenging fracture situation,” says Babst. “With support from master surgeons, participants will be able to learn or repeat rarely encountered situations. In addition, they will discuss in small groups the results achieved, as well as complex surgeries performed by faculty.”

That approach enhances the AO educational framework by introducing prefractured specimens and allows lectures to be reduced to approaches and tactics, with expert faculty providing practical feedback that can immediately be applied to the fractured specimen.

“The documented steps of reduction and temporary fixation can be shown to the whole group of participants, and both difficulties encountered and their solutions can be discussed in the group,” Babst says. “Instead of having sequential instruction with different modules like lectures, discussions, and practical exercises with bone models and anatomy, participants can operate on cases as they would in reality, encountering all of the challenges of a complex fracture situation, with the same soft tissue envelope and the same view through the selected approach and the C-arm view.”