A Randomized Trial of Preoperative Practice in a Simulated Operative Environment: 3D Printed Pilon Model Improves Resident Performance


This study assessed the eff ect of preoperative planning using a 3D-printed periarticular fracture model on operative performance. A complex pilon fracture was 3D-printed, and a preoperative plan was developed. Orthopaedic surgery residents (n = 20) were randomized into two groups. Group 1 performed routine preoperative planning, while Group 2 was also practiced using a 3D-printed construct before performing fi xation of the 3D-printed model. Resident performance was assessed using a video motion capture system and evaluated by blinded reviewers. Three residents (3D group) completed fi xation within the allott ed 45 minutes. The 3D group had less hand distance traveled for step 1 (89 m vs. 162 m, p = 0.04). The 3D group had bett er performance on three of the four components and more acceptable reductions (6 vs. 0, p = 0.009). Average global rating scale was higher in the 3D group (3.0 vs. 1.7, p = 0.0095). Use of 3D-printed models for preoperative planning improved resident performance. (Journal of Surgical Orthopaedic Advances 31(3):187–192, 2022)

Key words: resident education, 3D-printed fracture model, preoperative planning, fracture fi xation, simulated operative environment, simulation-based training

Kevin D. Phelps, MD; Olivia M. Rice, MD; John A. Ruder, MD; Rachel B. Seymour, PhD; Joshua C. Patt, MD, MPH; Madhav A. Karunakar, MD; and Stephen H. Sims, MD