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Impact of a Three-Dimensional “Hands-On” Anatomic Teaching Module on Acetabular Fracture Pattern Recognition by Orthopaedic Residents
Erik Hansen, MD1; Meir Marmor, MD2; Amir Matityahu, MD2
1 Department of Orthopaedic Surgery, University of California San Francisco, 500 Parnassus Avenue, Box 0728-MU 320W, San Francisco, CA 94143. E-mail address for E. Hansen: erik.hansen415@gmail.com
2 Orthopaedic Trauma Institute, San Francisco General Hospital, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110
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Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Dec 05;94(23):e177 1-7. doi: 10.2106/JBJS.K.00840
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Much of the difficulty in understanding acetabular fracture patterns is due to the complex three-dimensional relationship of the acetabulum to the greater pelvis. We hypothesized that combining three-dimensional “hands-on” anatomic models with two-dimensional informational teaching sheets would improve the ability of orthopaedic residents to accurately classify acetabular fracture patterns and aid in preoperative surgical approach selection.


Thirty-five orthopaedic residents from two programs accredited by the Accreditation Council for Graduate Medical Education participated in this prospective study. Twenty-question quizzes based on radiographs and computed tomography images of acetabular fractures tested the ability of the residents to accurately classify these fractures. One-half of the residents had access to informational teaching sheets only, and the other group had access to three-dimensional pelvic models of the fractures in addition to the informational sheets.


There was a positive correlation between the postgraduate year in training and the mean pre-intervention quiz score (r2 = 0.89). The mean improvement in the quiz score was 15% ± 15% for first and second-year residents compared with 3% ± 12% for fourth and fifth-year residents (p = 0.04). The resident group that used the three-dimensional “hands-on” models showed greater post-intervention improvement in the quiz score.


In this preliminary study, active learning that incorporated three-dimensional ”hands-on” pelvic models improved the ability of orthopaedic residents to accurately classify acetabular fracture patterns compared with use of informational teaching sheets alone.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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