Background: Surgery for hand trauma accounts for a significant proportion of the plastic surgery
training curriculum. The aim of this article is to create a standardized simulation training module
for hand fracture fixation with Kirschner wire (K-wire) techniques for residents in order to create
a standardized hand-training framework that universally hones their skill and prepares them for
their first encounter in a clinical setting.
Methods: A step-ladder approach training with six levels of difficulty on three-dimensional (3D)
printed ex-vivo hand biomimetics was employed on a cohort of 20 plastic surgery residents (n=20).
Assessment of skills using a score system (global rating scale) was performed in the beginning and
the end of the module by hand experts of our unit.
Results: The overall average score of the cohort pre- and post-assessment were 23.75/40 (59.4%)
and 34.7/40 (86.8%) respectively. Significant (p<0.01) difference of improvement of skills was
noted on all trainees. All trainees confirmed that the simulated models provided in this module
were akin to the patient scenario and noted that it helped them improve their skills with regards to
K-wire fixation techniques including improvement of their understanding of the 3D bone
topography.
Conclusion: We demonstrate a standardized simulation training framework that employs 3D
printed ex-vivo hand biomimetics proven to improve the skills of residents and which paves the
way to more universal, standardized and validated training across hand-surgery. This is, to our
knowledge, the first standardised method of simulated training on such hand surgical cases.