RU2715146C1 - Simulator for obtaining practical skills in surgical management of trauma-orthopedic pathologies of mammals and method of obtaining practical skills in surgical management of trauma-orthopedic pathologies of mammals - Google Patents

Abstract

FIELD: training; medicine.

SUBSTANCE: group of inventions relates to medical education means. Two types of simulators are used in training surgical management of trauma-orthopedic pathology of mammals, and method of training. One of the simulators comprises anatomically accurate copies of segments of a mammalian skeleton made of multicomponent polymer materials with fractures, is semi-open, comprising a body with contour channels to accommodate removable elements imitating bones, which are fixed by bridges, wherein the simulator body is made of polymer elastic materials with elastoplastic properties, corresponding to mammal soft tissues characteristics, and the elements imitating bone of the skeleton are made from materials with elastoplastic properties corresponding to characteristics of bones of mammals. Other simulator comprises a closed body, and along the fracture line, bone fragments are fitted with magnets with similar poles directed towards each other, and sensors are installed in the fracture line to visualize the result of the joint. In the method implementation both simulators are used.

EFFECT: inventions facilitate formation of trainees' skills in operative treatment of fractures and locomotor diseases in mammals, allow objectively evaluating learning outcomes.

3 cl, 11 dwg, 1 tbl

Description

The invention relates to medicine, more specifically traumatology and orthopedics, applicable for teaching practical skills in the surgical treatment of trauma and orthopedic pathology in phantom courses using mammalian simulators.

The development of phantom courses using high-tech simulator simulators to improve the professional competence of practicing doctors and students is an urgent task.

The Known Method of simulation training for prosthetics with artificial crowns (RU 2658456, IPC А61С 13/0003, 2018) for the formation of manual skills in dental students.

The closest in technical essence to the proposed method is a method for assessing the survival of acquired practical skills in the preparation of hard tooth tissues (RU 2578813, IPC G09B 23/28, 2014), which includes obtaining practical skills on a simulator followed by an assessment of practical skills. When working on a dental simulator "CDS-100" evaluate: preparation of a treatment plan, errors in the volume of preparation, complications of preparation. Then, according to the set criteria, the teacher assesses the student's practical skills. The main disadvantage of the known technical solution is that it is designed for use in dentistry. The literature available to the author does not contain information on the methods of acquiring theoretical and practical skills in orthopedics and osteosynthesis in phantom courses. The proposed method fills this gap.

The closest in technical essence to the proposed device is a Demonstration three-dimensional model of the skeleton of an animal (RU 2664966, IPC G09B 23/36, 2017), which allows you to recreate a full-sized copy of the skeleton of an animal with observance of external similarity and the ability to display motor functions. The model of the animal’s skeleton, consisting of anatomically exact copies of the segments of the animal’s skeleton, is made of polyurethane-based plastics, and permanent magnets are used to connect the bones of the limbs and joints, which provide flexibility and mobility. The disadvantage of this device is that it is intended primarily for exhibition purposes, and as a material for training, it has limitations that do not allow the full development of surgical procedures, including external and internal osteosynthesis.

The objective of the invention is to improve the design of mammalian simulators and the formation in students of phantom courses of skills for the surgical treatment of fractures and diseases of the musculoskeletal system in mammals using various methods of osteosynthesis, including the formation of an understanding of the stages of treatment and an objective assessment of learning outcomes.

Technical result from the use of the invention Simulators for phantom courses and a method for conducting a phantom course to obtain theoretical knowledge and practical skills in traumatic orthopedic pathology of mammals:

- the use of simulators for phantom training courses, which have visibility, informativeness, unlimited ability to present variants of occurring fractures and orthopedic pathologies within the same model, low cost advantages that allow to develop methods of surgical intervention in traumatology and orthopedics, using options for external and internal osteosynthesis;

- development of a training phantom course that provides mastery of theoretical knowledge and practical manual skills for treating injuries and pathologies of the chest and pelvic limbs, pelvis, and spinal column; allowing on phantom models-simulators to conduct training with the correction of errors, to carry out an objective assessment of the level of knowledge and practical skills in the framework of the proposed methods.

The claimed technical result is achieved by the fact that in the design of simulators for phantom courses to obtain theoretical knowledge and practical skills in trauma and orthopedic pathology of mammals, which are anatomically exact copies of segments of the skeleton of a mammal made of polymer material with fractures connected by magnets, a number of changes are made that characterize the novelty :

- simulators are performed in two versions, half-open and closed, containing a housing with contour channels and removable elements imitating bones placed in them;

- in semi-open simulators, elements imitating bones are fixed by jumpers;

- in closed simulators, magnets are placed in the bone imitating elements with fractures at a certain distance from the fracture line, with the poles pointing towards each other with the same poles, and sensors are mounted in the fracture line to visualize the result of the connection;

- the simulator body is made of polymer elastic materials close in density and elasticity to the soft tissues of mammals;

- elements imitating the bones of the skeleton are made of materials whose density is close to the density of the bones of mammals.

The claimed technical result is also achieved by the fact that the Method of conducting a phantom course to obtain theoretical knowledge and practical skills in trauma and orthopedic pathology of mammals, including obtaining practical skills on a simulator with subsequent assessment of practical skills, is supplemented by a theoretical part. At all stages of training, simulators are used that functionally and anatomically accurately reproduce in full size: chest limbs, pelvic limbs, axial skeleton, including the pelvis and vertebral column. Obtaining theoretical knowledge and practical skills is carried out on simulators of a half-open type, and closed-type simulators are used for examination purposes.

In common with well-known technical solutions is the use of phantoms to acquire skills during phantom courses.

The invention is illustrated by illustrations and a table:

FIG. 1 - simulators of a half-open type, a - a phantom of a person’s hand, b - a phantom of a dog’s legs;

FIG. 2 - closed simulators;

FIG. 3 - closed-type simulators, which show magnets connected to sensors: a - a phantom of a person’s hand, b - a phantom of a dog’s legs;

Fig 4 - simulator half-open type: a - from the outside, b - from the inside;

FIG. 5 - simulator half-open type with imitation of a fracture of the humerus;

FIG. 6 - simulator half-open type with imitation of a fracture of the bones of the forearm;

FIG. 7 - drilling a rod into a phantom simulator half-open type;

FIG. 8 - simulator half-open type with installed proximal support;

FIG. 9 - simulator half-open type with installed distal support;

FIG. 10 - analysis of the spatial position of the bone fragment with the installed distal support;

FIG. 11 - simulator of a half-open type with an external fixation device superimposed: a - the outer side, b - the inner side.

Table. The content of the phantom course.

Mammalian simulators for phantom courses are the main segments of the musculoskeletal system that functionally and anatomically accurately reproduce in full size the chest limbs, pelvic limbs, axial skeleton, including the pelvis and vertebral column.

In a preferred embodiment, the simulators are made half-open (Fig. 1, a, b) and closed (Fig. 2). The semi-open type of simulator is designed to master the practical skills of osteosynthesis, therefore it is open on one side and has access to elements like skeleton bones. The closed type of simulator designed for examination purposes is an exact copy of the skeleton segment with imitation of muscle tissue.

Each semi-open type simulator contains (Fig. 1 a, b) a housing 1 with contour channels 2 for accommodating removable elements 3 simulating bones, and a jumper 4 to prevent elements from falling out of the contour channels 2. The contour channels 2 in their shape repeat the shape of the elements 3, imitating bones. On elements 3, characteristic fractures 5 were performed to model the treatment of injuries with all types of osteosynthesis. Case 1 of simulators of all types, being an exact copy of the skeleton segment, is made of multicomponent polymer elastic materials similar in density and elasticity to the soft tissues of mammals. Elements 3 imitating the bones of the skeleton are made of polymer materials, the density of which is close to the density of the bones of mammals.

Closed simulators (Fig. 2) are an exact anatomical copy of a segment of the skeleton of a mammal, and elements 3 imitating the bones of the skeleton are completely hidden by polymeric material. Fragments of bones with imitation of fractures 5 are connected using permanent magnets 6, 7 (Fig. 3, a, b), for this, magnets are inserted into bone fragments at a certain distance from the fracture line, with the same poles directed to each other, connected to sensors 8. When the electric circuit is closed when the fragments are correctly combined, a light signal appears, which is an objective system for visualizing the result of mastering osteosynthesis techniques.

Simulators due to the elasticity of the material allow reproducing displacement, distraction, extraction of conditional bones. Simulators allow for any position of the joints, as well as drilling bones and staging any hardware design for both external and internal osteosynthesis. The case of the simulator is easily restored after operation, for this it is enough to fill the incisions and openings with polymer material, which ensures their repeated use. Simulators are economical because the cost of their manufacture is much less than the cost of foreign analogues.

The phantom course for obtaining theoretical knowledge and practical skills in traumatic orthopedic pathology of mammals consists of a theoretical, practical part and a final exam (see. Table. Contents of the phantom course). The phantom course involves the use of simulators that copy the main segments of the musculoskeletal system of mammals, including simulations of the chest limbs, simulators of the pelvic limbs, simulators of the axial skeleton, for example, the pelvis and spinal column. In the theoretical part, students receive knowledge on trauma and fracture, bone reconstruction, osteosynthesis of mammals, the training of which is accompanied by a demonstration on semi-open phantom simulators. The main task is to master the theoretical basis for the surgical treatment of fractures and diseases of the musculoskeletal system, using external and internal osteosynthesis.

The practical part involves the formation of practical skills and training on semi-open simulators - from planning the surgical stage to installing structures of external or internal osteosynthesis. On semi-open simulators, as part of the phantom course, the techniques of external and internal osteosynthesis and the techniques of endoprosthetics of large joints (hip, knee ulnar), as well as access to the vertebrae with subsequent modeling of the installation of hardware systems and the approach to the spinal cord, are practically developed. Semi-open type simulators make it possible to simulate any fractures, select strategies for surgical procedures on the conditional bone, perform reconstructive operations with osteotomy on the conditional bones and joints with their change after training operations, forming clinical thinking, spatial positioning. Closed simulators on the exam visually demonstrate the level of mastery of practical skills.

Example

A group of students was given a course of lectures, the contents of which are presented in the Table, using semi-open mammalian simulators (phantoms) as an illustrative material, for example, a human hand phantom or a dog foot simulator. In the theoretical part, students received knowledge on trauma and fracture, bone reconstruction, mammalian osteosynthesis, as well as on the Veterinary Orthopedic Kit (VETERINARI ORTOPEDIC KIT, further VOK, Pat. 149175 Russian Federation, US 10045822, CN 105142562). The proposed theoretical base was the basis for the development of the practice of surgical treatment of fractures and diseases of the musculoskeletal system, using VOK for external osteosynthesis, or METRIC & METRIC system for bone osteosynthesis (US Pat. 2674932, Russian Federation).

Then each student, having at his disposal one of the semi-open simulators that functionally and anatomically accurately reproduces in full size: chest limbs, pelvic limbs, axial skeleton, including the pelvis and spinal column, practiced surgical skills with external and internal osteosynthesis, or skills of approach to the spinal column and spinal cord, etc. Practical exercises (Fig. 4) formed a spatial representation of the studied fracture area in the students (Fig. 5), made it possible to correctly assess the soft tissue-bone ratio factor (Fig. 6), evaluate joint function in the damaged area, and form a sensation touched the rod into the bone (Fig. 7), install the proximal (Fig. 8) and distal supports (Fig. 9), analyze the spatial position of the bone fragment with the distal support installed (Fig. 10), apply an external fixation device ( u. 11). After the practical part of the phantom course was completed, the shells of all half-open simulators were restored by pouring with multicomponent polymer material. At the exam, the student received a closed simulator with hidden fractures, performed all the necessary manipulations, applying the knowledge and skills gained. If, after superimposing a hardware structure on a fracture, the sensor reacted with a light signal, then this indicated that the correct manipulations were performed and that the phantom course was successfully completed.

Claims (3)

1. A simulator for obtaining practical skills in the surgical treatment of traumatic orthopedic pathologies of mammals, which is anatomically accurate copies of segments of the skeleton of a mammal made of multicomponent polymeric materials with fractures, characterized in that the simulator is half-open, containing a body with contour channels for placement in them removable elements simulating bones, which are fixed by jumpers, and the simulator case is made of polymer elastic materials with elastic elastic properties corresponding to the characteristics of soft mammalian tissue, and elements that simulate bones of the skeleton are made from materials with elastic properties, characteristics relevant bones of mammals. 2. A simulator for obtaining practical skills in the surgical treatment of traumatic orthopedic pathologies of mammals, which is anatomically accurate copies of segments of the skeleton of a mammal made of multicomponent polymeric materials with fractures and built-in magnets, characterized in that the simulator contains a closed case with internal contour channels for placement they have removable elements imitating bones, and along the fracture line magnets of the same name are inserted into the bone fragments, directed to each other, and sensors were installed in the fracture line to visualize the result of the connection, and the simulator case is made of polymer elastic materials with elastic properties that correspond to the characteristics of mammalian soft tissues, and elements that imitate skeleton bones are made of materials with elastic properties corresponding to the characteristics mammalian bones. 3. A method of obtaining practical skills in the surgical treatment of traumatic orthopedic pathology of mammals, including obtaining practical skills on a simulator followed by an assessment of practical skills, characterized in that the course is supplemented by a theoretical part, at all stages of training, simulators are used that functionally and anatomically accurately reproduce in natural size: chest limbs, pelvic limbs, axial skeleton, including the pelvis and spinal column, and obtaining theoretical knowledge and practical skills s simulations performed on the half-open type, and is used for examination purposes simulators closed.

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