Fluoroscopy use analysis of cephalomedullary nail procedures performed by orthopedic surgical residents

Hip fractures are a common and dangerous occurrence in the United States. The repairs for this type of injury are often completed using a cephalomedullary nail. Orthopedic surgical residents will often learn this procedure early in their careers, and there is a need for more quantitative metrics with which to assess resident performance. Doing so will lead to more targeted training and higher educational standards with the goal of improving patient outcomes.

This work used fluoroscopy and the behaviors contained within as its assessment metric, and discussed when and where fluoroscopy is being used, as well as how residents are controlling their tools during the procedure. The experiments found that the first wire navigation task required the most images and time, but more experienced residents did not use more fluoroscopy than their junior counterparts. Instead, residents who consistently made large corrections typically required more fluoroscopy in both the OR and simulator environments.