Reduction in ionizing radiation exposure during minimally invasive anterior plate osteosynthesis of distal radius fracture: Naive versus deliberate practice.
Fiche publication
Date publication
décembre 2021
Journal
Hand surgery & rehabilitation
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MEYER Nicolas
Tous les auteurs :
Delbarre M, Hidalgo Diaz JJ, Xavier F, Meyer N, Sapa MC, Liverneaux P
Lien Pubmed
Résumé
This study aimed to decrease surgeon exposure to ionizing radiation through a new learning technique, "deliberate practice", which consists in improving performance by setting goals with feedback. The hypothesis was that exposure to ionizing radiation during distal radius fracture surgery using the minimally invasive plate osteosynthesis (MIPO) technique decreased faster with "deliberate" practice than with "naïve" practice. Radiographic dosimetry was measured in the first 30 fractures operated on by MIPO by 6 surgeons. The first 3 surgeons operated "naively" (Group 1) and the next 3 according to the "deliberate" procedure (Group 2). Group 2 received weekly feedback (number of exposed hands, number of fluoroscopic views, exposure duration, and X-ray dose). An expert, using fluoroscopic images and surgical videos, provided suggestions for improvement. Mean number of exposed hands was 23.66 in Group 1 and 1.9 in Group 2. Mean number of fluoroscopic views was 78.31 and 35.0, respectively. Mean X-ray exposure time was 74.34 and 32.89 seconds, respectively. Mean dosimetry was 1.40 mGy (and 0.59 mGy, respectively. The hypothesis was thus confirmed: dosimetry decreased faster in Group 2 than in Group 1. Teaching this deliberate practice should be generalized, to decrease the growth phase and increase the plateau phase of the learning curve.
Mots clés
Deliberate practice, Formation chirurgicale, Ionizing radiation, MIPO, Pratique délibérée, Radiations ionisantes, Rayons X, Surgical education, X-rays
Référence
Hand Surg Rehabil. 2021 Dec 14;: