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Topic:

Femoral Anteversion

Issue:

Thigh

Category:

Developmental

Title:

Eye of the Carpenter: How Well do Orthopaedic Surgeons Estimate Angular Measurements in Derotational Osteotomies?

Author:

Chaclas, Nathan BS; Dyer, Olivia BS; Mayers, Alexander MD; Wheatley, Benjamin PhD; Grandizio, Louis C. DO; Seeley, Mark MD

Journal:

Journal of Pediatric Orthopaedics

Date:

February 2024

Reference:

44(2): p 112-116, DOI: 10.1097/BPO.0000000000002525

Level Of Evidence:

III

# of Patients:

30

Study Type:

Experimental study with training intervention

Location:

Single institution

Summary:

The study assesses the accuracy and inter-rater reliability of orthopaedic surgeons in estimating angular measurements during femoral derotational osteotomies and evaluates the effect of training on their performance.

Methods:

A rotational femur model was used for testing. Surgeons and nonsurgeons were asked to create target angles of 15, 30, 45, and 60 degrees using only Kirschner wires and bone marks. Surgeons were randomized into a trained and untrained group. Independent and paired t-tests were performed to analyze accuracy and variability between groups.

Exclusions:

Patients with prior experience in femoral derotational osteotomies were excluded from the nonsurgeon group

Results:

The surgeon cohort had significantly lower error and variability compared to the nonsurgeon cohort. The trained surgeon cohort had significantly better performance than the untrained cohort. In the nonsurgeon group, the use of wires for angle creation resulted in significantly less error compared to using only bone marks.

Conclusions:

Surgeons showed considerable variability in their ability to estimate angles, highlighting the need for improved training in basic geometric principles. The training intervention was effective and cost-effective, suggesting that better spatial orientation in orthopaedic education could enhance surgical outcomes, especially for femoral derotational osteotomies.

Relevance:

Limitations:

Perspective:

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