JAAOS - 2026-09-04 - Journal Article
Development and Preliminary Validation of a Tactile, 3D-Printed Kirschner Wire Pinning Simulator for Orthopaedic Surgery Residents.
Rasheed H, Monovoukas D, Rooney DM, Whyte NSB
Topics
Key Takeaway
A $53 3D-printed K-wire pinning simulator scored 4.8/5 for teaching triangulation and 4.4/5 for motor skill development based on expert content validation.
Summary Depth
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Summary
The authors developed a low-fidelity, $53 K-wire pinning simulator comprising a bone model, soft-tissue overlay, light-fixture radiograph surrogate, and electronic feedback component to address limited extracurricular procedural training opportunities for residents. Five fellowship-trained pediatric orthopaedic surgeons rated the simulator using Likert scales for physical fidelity and skill transferability. Cortical feel scores peaked at 3.4/5, medullary canal feel at 3.2/5, and transferability ratings reached 4.8/5 for triangulation and 4.4/5 for motor skill improvement.
Key Limitation
No resident performance data were collected, so transfer validity—whether simulator training actually improves intraoperative K-wire placement accuracy or efficiency—remains entirely undemonstrated.
Original Abstract
INTRODUCTION
There are limited opportunities for orthopaedic trainees to practice placing Kirschner wires for fracture fixation outside the operating room. We created an inexpensive, low-fidelity simulator to meet this need.
METHODS
The simulator is composed of a bone model, soft-tissue model, light fixture "radiograph," and an electronic component and costs US$53. Validation evidence relevant to test content was evaluated by five fellowship-trained pediatric orthopaedic surgeons using a Likert scale to assess the physical characteristics of the models and their ability to result in transfer of skills to the operating room.
RESULTS
Model 3 had the highest average score for feel of the near (3.4) and far (3.4) cortex. Model 2 had the highest average score for feel of the medullary canal (3.2) and pin visualization (2.6). The simulator had high scores for ease of use and implementation and was rated highly for its ability to support residents' learning to triangulate to a defined target (4.8) and improve motor skills (4.4).
DISCUSSION
We were able to create an inexpensive, low-fidelity simulator with potential for high transferability, which can be used by orthopaedic surgery residents to improve their motor skills in a low risk, high-reward environment.