Roll-out of a one-of-a-kind fracture challenge course, simulating real-life operating room situations.

AO Trauma Course—Fracture Challenge: How Masters Manage Scapular Fractures

31 August 2020

Fracture challenge

AO Trauma is delighted to announce the European roll-out of its new fracture challenge courses on scapular fractures. With its new, one-of-a-kind course—taking place on November 13–14 in Rotterdam, NL—the AO takes another significant step forward in its mission to promote excellence in patient care and outcomes in trauma and musculoskeletal disorders. With pre-fractured bone specimens, demanding and complex fractures will be simulated.

Challenge courses employing pre-fractured bone specimens are designed to provide orthopedic trauma surgeons with a virtually complete OR simulation says AO Trauma Europe and Southern Africa Education Committee Chair Reto Babst.

“Pre-fractured anatomical specimens allow us to simulate reality as closely as possible, since participants will have to plan the treatment with the same imaging modalities at hand in the hospital,” Babst explains. “Participants will perform surgery according to plan using the same approaches and encountering the same anatomical conditions as in reality, except for blood flow. Each participant will reduce the fracture, maintain the reduction, and fix the fracture, documenting each step, just as in real life.”

Real-life surgery simulation

In preoperative lab sessions, each three-person group of participants will receive a pre-fractured specimen along with identical X-rays, computed tomography (CT) scans, 3D CT scans, and time to devise a preoperative plan. Each group will then take its plans into the simulated OR to treat the case according to plan. Each step of the process is to be documented with the help of C-arm fluoroscopic imaging and, at the end of the wet lab session, each group will present its case, using the fluoroscopic images and the fixed pre-fractured specimen.

A unique chance to learn from masters

“The participant gets hand-on simulation training by performing real surgery in a real, challenging fracture situation,” says Babst. “With support from master surgeons, participants will be able to learn or repeat rarely encountered situations. In addition, they will discuss in small groups the results achieved, as well as complex surgeries performed by faculty.”

That approach enhances the AO educational framework by introducing pre-fractured specimens and allows lectures to be reduced to approaches and tactics, with expert faculty providing practical feedback that can immediately be applied to the fractured specimen.

“The documented steps of reduction and temporary fixation can be shown to the whole group of participants, and both difficulties encountered and their solutions can be discussed in the group,” Babst says. “Instead of having sequential instruction with different modules like lectures, discussions, and practical exercises with bone models and anatomy, participants can operate on cases as they would in reality, encountering all of the challenges of a complex fracture situation, with the same soft tissue envelope and the same view through the selected approach and the C-arm view.”


Targeted to orthopedic trauma surgeons with good knowledge, challenge courses go an extra step by providing exposure to challenging OR situations and coaching by master surgeons who will share their techniques and tricks.

Course prerequisites include completion of the AO basic and advanced principles courses, active involvement in orthopedic trauma management and, preferably, at least five years of post-residency trauma experience. Participants should be prepared to share their ideas and able to communicate well in English.

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