The surgeon and his tools-the case for a focused orthopaedic theatre induction programmeReport as inadecuate




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BMC Research Notes

, 1:104

First Online: 28 October 2008Received: 08 June 2008Accepted: 28 October 2008DOI: 10.1186-1756-0500-1-104

Cite this article as: Kumar, A.S., Oakley, J., Wong, S.K. et al. BMC Res Notes 2008 1: 104. doi:10.1186-1756-0500-1-104

Abstract

BackgroundInduction programme for trainee doctors in the UK generally do not focus on the surgical aspects of their jobs. In this context we decided to conduct a telephonic survey among the hospitals belonging to three orthopaedic training regions in the UK from the point of view of the diversity of instrumentations and implants used for index procedures.

ResultsWe chose four index trauma and orthopaedic procedures Total hip replacement, total knee replacement, intramedullary nailing and external fixator systems for long bone fractures. A telephonic survey was done in six NHS trust hospitals which were part of an orthopaedic training rotation 2 from England, 2 from Wales and 2 from Scotland. In total there were 39 different instrumentation systems for these 4 index procedures in the 6 trusts see table 1. These comprise 12 Total hip replacement THR systems, 14 total knee replacement TKR systems, 9 intra-medullary nailing systems, and 4 external fixator systems. The number of different systems for each trust ranged from 7 to 19. There is a vast array of implants and instrumentation systems in each trust, as highlighted by our survey. The surgical tools are not the same in each hospitals. This situation is more complicated when trainees move to new hospitals as part of training rotations.Table 1Number of implants-instrumentations used in each of the 6 UK trusts 3 training regions.

IMPLANT

E1

E2

W1

W2

S1

S2

Total Knee Replacement

4

5

2

4

3

2

Total Hip Replacement

3

4

3

6

3

3

Intramnedullary nailing

2

1

1

6

2

3

External fixators

2

3

2

2

1

1

TOTAL

11

13

8

18

9

9

E = England, W = Wales, S = Scotland

ConclusionIn view of this we feel that more focused theatre based induction programmes for higher surgical trainees is advocated in each hospital trust so trainees can familiarise themselves with the tools available to them. This could include discussion with the consultants and senior theatre staff along with representatives from the companies supplying the implants and instrumentation systems.

J Oakley, Shaun KS Wong and Steve J Philips contributed equally to this work.

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Author: AJ Shyam Kumar - J Oakley - Shaun KS Wong - Steve J Philips

Source: https://link.springer.com/







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