Extremities

Targeted teaching improves junior doctors’ management of fractures

The addition of training focused on fracture reduction and molding technique to orthopedic juniors’ induction teaching or as a separate session helped improve rates of fracture redisplacement, according to a study.

 Researchers held a targeted teaching session on fracture reduction and cast molding for a group of junior doctors who retrospectively reviewed all dorsally angulated distal radius fractures treated in plaster over a 4-week period (group one), followed by a subsequent 4-week prospective review (group two). A single senior orthopaedic trainee used predetermined criteria to review radiographs before manipulation, after manipulation and at follow-up. Main outcome measures included adequate fracture reduction, plaster molding, redisplacement, and further intervention before and after the targeted intervention.

Study results showed 85% of patients had adequate fracture reduction in group one; however, only 36% showed adequate molding. In group two, 94% showed adequate reduction and 65% showed adequate molding. Group two also had an improvement in redisplacement rate, from 65% to 44%.

The researchers found a redisplacement rate of 20% for adequately reduced and molded fractures, compared with a rate of approximately 90% for adequately reduced but inadequately molded cases, in both groups. The rate of further intervention improved from 27% to 8% between the two groups, according to the researchers.

Disclosure: The authors have no relevant financial disclosures.

Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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