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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.