CHEN, Wilson1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA.... [ view full abstract ]
CHEN, Wilson1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA. Departments of Orthopaedics5, General Surgery6 and Sports Medicine7, Samaritan Health Services, Corvallis, OR. USA. Departments of Surgery8, Orthopaedics & Rehabilitation9, Oregon Health & Science University, Portland, OR. USA.
INTRODUCTION. Tibula-fibula (TF) fractures are a relatively common fracture presenting among trauma to emergency services. Ultrasound (US) has been proven to be effective in identifying fractures, especially for displaced fractures by inspection of the skeletal cortex. SECTRA visualization table (SVT) is a technology rendering CT/MRI DICOM files into 3D. SVT-ORTHO is a branch program that assists in restoring anatomy for orthopedic surgery. The objective of this study was to see if medical students could recognize and assess TF fractures from undissected cadaveric tissue following an imaging protocol involving SVT imaging. METHODS. A literature search was conducted regarding the integration of US and 3D-CT software of TF from donor cadavers and healthy volunteers. First-year medical students (MS1) dissected the TF region, and then viewed TF x-rays, CT, and SVT. 18 MS1 used 5-12 and 18 MHz probes on the TF during dissection and were divided into formal 20-min tutorial groups three times weekly to view and assess TF fractures on the SVT. Students were given the autonomy to access US and SVT outside of formal hours. Each had a minute and a half to engage with SVT before they were asked to leave the room and complete an illustration (AP and PA view) of the fracture they had examined. 24 hours later, students were asked to draw the AP and PA views of the same fracture after an additional exam with the US. RESULTS.Literature search revealed no known studies. Students successfully conducted the 5-12 and 18 MHz probes to identify the TF and were able to utilize the SECTRA with success to better understand the fracture. DISCUSSION. Approximately 80-90% of TF fractures are displaced, most of which require surgery. Typical protocol for TF fractures includes X-rays with CT scans. US is a rapidly evolving tool for fracture recognition that, used during triage or on early admission, may expedite and improve patient care. The SVT-ORTHO was designed to assist in the rehearsing of morphologies for orthopedic surgery. With combined palpations, visualizations, and dissections, students were able to use US to improve in accuracy on subsequent illustrations. CONCLUSION. This study used various viewing mediums in chronological order with positive identification of the tib-fib, suggesting that this technique may be a useful teaching tool for ultrasound fracture identification.
Use of ultrasound in Undergraduate Medical Education , Use of ultrasound in Graduate Medical and Continuing Education , Technology
