Patterns in Bone Drilling Performance Before and After the 2017 Motors Skills Course of the Southwest Orthopaedic Trauma Association

Abstract

Background: Although experience within the operating room can help surgeons learn simple bone-drilling techniques, outside training may be better suited for complex procedures. We adapted a rotary handpiece to evaluate bone drilling skills of orthopaedic resident physicians during the 2017 motor skills course of the Southwest Orthopaedic Trauma Association (SWOTA). Methods: A total of 25 postgraduate year-one orthopaedic residents from seven institutions were asked to perform a bicortical drilling task three times before and after attending a motor skills course. Kinetic and kinematic data were collected using force, acceleration, and visual sensors. Results: A total of 16 parameters were measured. Variables statistically significant after the course were as follows: over-penetration (28.8-18.2 mm), skiving (22%-6%), preparation time (27.3-9.65 seconds), drilling time (8.28-9.35 seconds), palmar-dorsal vibration (1.76- 2.05 m/s2), maximum drilling force (58.56-84.30 N), and maximum revolution per minute (RPM; 917-944). The interdependence of these parameters taken separately for pre- and post-course performance are presented. Notable correlations include: over-penetration with force (0.65), palmar-dorsal toggle (0.65), vibration in palmar-dorsal (0.53), time (-0.41), and RPM (-0.36); time with both RPM (0.38) and palmar-dorsal toggle (-0.40); and force with both RPM (-0.41) and palmardorsal toggle (0.32). Conclusions: The correlation data presented provide insight into patterns between measured parameters regarding where performance metrics are and are not coupled. Evidence for motor skill acquisition across both short- and long-time scales are elucidated

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