AO Trauma Course―Basic Principles of Fracture Management

DAY 1

Start End Duration Details

7:15 7:45 0:30 Registration
7:45 8:00 0:15 Welcome
Group A & B
8:00 8:15 0:15 The AO world—from history to lifelong learning
Bone healing and the effect of patient factors and injury mechanism on
8:15 8:30 0:15
fracture management
8:30 8:45 0:15 The soft-tissue injury—a high priority consideration
8:45 9:05 0:20 Absolute stability: biomechanics, techniques and fracture healing
9:05 9:25 0:20 Relative Stability: biomechanics, techniques and fracture healing
9:25 9:45 0:20 The biology of bone healing
9:45 9:55 0:10 Muller AO classification of Fractures - long bones
9:55 10:10 0:15 Q&A
10:10 10:30 0:20 Tea Break
Group A Group B
Skills Lab
A. Torque measurement of bone screws (10)
B. Soft-tissue penetration during drilling (10)
C. Heat generation during drilling (10)
Small group discussion 1:
D. Mechanics of bone fractures (10)
Discussion on general principles, classification, concepts of
10:30 12:30 2:00 E. Techniques of reduction, part 1 (10) 10:30 11:30 1:00
stability, their influence on bone healing, and how to apply
F. Techniques of reduction, part 2 (10)
implants to achieve appropriate stability
G. Mechanics of intramedullary fixation (10)
H. Mechanics of plate fixation (10)
J. Fracture healing and plate fixation (10)
K. Damaged implant removal (10)
Practical exercise 1:
Small group discussion 1: Internal fixation with screws and plates—absolute stability
Discussion on general principles, classification, concepts of stability, • Video: 00139, part 1 (lag screw, position screw, plate with
12:30 13:30 1:00 11:30 12:30 1:00
their influence on bone healing, and how to apply implants to achieve overbending)
appropriate stability • Bone model: 0066, 1142
• Power tool (video only)
13:30 14:15 0:45 Lunch 12:30 13:15 0:45 Lunch

Skills Lab
A. Torque measurement of bone screws (10)
B. Soft-tissue penetration during drilling (10)
Practical exercise 1:
C. Heat generation during drilling (10)
Internal fixation with screws and plates—absolute stability
D. Mechanics of bone fractures (10)
• Video: 00139, part 1 (lag screw, position screw, plate with
14:15 15:15 1:00 13:15 15:15 2:00 E. Techniques of reduction, part 1 (10)
overbending)
F. Techniques of reduction, part 2 (10)
• Bone model: 0066, 1142
G. Mechanics of intramedullary fixation (10)
• Power tool (video only)
H. Mechanics of plate fixation (10)
J. Fracture healing and plate fixation (10)
K. Damaged implant removal (10)
Principles of diaphyseal fracture management—what is important in
15:15 15:35 0:20 15:15 15:35 0:20 Tea Break
treating these fractures?
Practical exercise 2:
Principle of the internal fixator using the locking compression
plate (LCP)
15:35 15:50 0:15 Intramedullary nailing—to ream or not to ream? 15:35 16:35 1:00 • Video: 00112
• Bone model: 1142
• Bone model: 0068 (bridge plating MIPO)
• Bone model: 0081 (angular stability in osteoporotic bone)
Principles of diaphyseal fracture management—what is important
15:50 16:05 0:15 Fracture fixation using locking plates 16:35 16:55 0:20
in treating these fractures?
16:05 16:20 0:15 Q&A 16:55 17:10 0:15 Intramedullary nailing—to ream or not to ream?
Practical exercise 2
Principle of the internal fixator using the locking compression plate
(LCP)
16:20 17:20 1:00 • Video: 00112 17:10 17:25 0:15 Fracture fixation using locking plates
• Bone model: 1142
• Bone model: 0068 (bridge plating MIPO)
• Bone model: 0081 (angular stability in osteoporotic bone)
17:20 17:40 0:20 Tea Break 17:25 17:40 0:15 Q&A
Group A & B
Principles of articular fracture management—how do they differ from
17:40 17:55 0:15
diaphyseal fractures?
Forearm fractures—understanding the principles of diaphyseal and
17:55 18:10 0:15
articular fractures
18:10 18:25 0:15 Preoperative planning—rationale and how to do it
18:25 18:40 0:15 Summary of the day
DAY 2

Start End Duration Details Start End Duration Details

7:15 7:45 0:30 Registration
Group A & B (Lecture room)

Preoperative planning—“plan your forearm operation”

7:45 8:45 1:00
Templating exercise

Group A Group B
Practical exercise 3: Reamed intramedullary (IM) nailing
This nailing exercise can be done for a tibial shaft fracture
or a femoral shaft fracture. Please choose only one of the
following options:
Small group discussion 2:
8:45 9:45 1:00 Tibial shaft fractures—IM nailing with the expert tibial nail 8:45 9:45 1:00 Management principles for the treatment of diaphyseal
(ETN) fractures
(with reaming)
• Video: 00130
• Bone model: 1149-01
• Bone model: ASLS perspex model
9:45 10:05 0:20 Tea Break 9:45 10:05 0:20 Tea Break

Practical exercise 3: Reamed intramedullary (IM) nailing

This nailing exercise can be done for a tibial shaft fracture
or a femoral shaft fracture. Please choose only one of the
following options:
Small group discussion 2:
10:05 11:05 1:00 Management principles for the treatment of diaphyseal 10:05 11:05 1:00 Tibial shaft fractures—IM nailing with the expert tibial nail
fractures (ETN)
(with reaming)
• Video: 00130
• Bone model: 1149-01
• Bone model: ASLS perspex model

Group A & B (Lecture room)

11:05 11:20 0:15 Tension Band Principle

11:20 11:35 0:15 Minimally invasive osteosynthesis (MIO)—when to use it?

11:35 11:50 0:15 Ankle fractures—a systematic approach to their fixation

11:50 12:00 0:10 Q&A

Group A Group B
Practical exercise 4:
Small group discussion 3:
Tension band wiring of the olecranon
12:00 12:30 0:30 12:00 13:00 1:00 Management principles for the treatment of articular
• Video: 00132
fractures
• Bone model: 6011
Practical exercise 5:
Management of a type 44C malleolar fracture
12:30 13:20 0:50 13:00 13:40 0:40 Lunch
• Video: 00138
• Bone model: LD3120
Practical exercise 4:
Tension band wiring of the olecranon
13:20 14:00 0:40 Lunch 13:40 14:10 0:30
• Video: 00132
• Bone model: 6011
Practical exercise 5:
Small group discussion 3:
Management of a type 44C malleolar fracture
14:00 15:00 1:00 Management principles for the treatment of articular 14:10 15:00 0:50
• Video: 00138
fractures
• Bone model: LD3120
Group A & B (Lecture room)
15:00 15:15 0:15 Femoral neck fractures
15:15 15:30 0:15 Trochanteric fractures
Group A Group B
Practical exercise 6

This practical exercise can be done with a dynamic hip

screw (DHS) or the TFN-Advanced proximal femoral nailing
system (TFNA). Please choose only one of the following
options:

1 demo for faculty demonstration

15:30 16:30 1:00 Intramedullary fixation of a trochanteric fracture using the 15:30 15:45 0:15 Distal femoral fractures—management principles
TFN-Advanced proximal femoral nailing system (TFNA)
• Video: 20256
• Bone model: LD2220.01

Hands-on for participants

Management of a trochanteric fracture using a DHS
• New video: 00137
• Bone model: LD2220.01
16:30 16:50 0:20 Tea Break 15:45 16:00 0:15 Introduction to tibial plateau fractures
16:50 17:05 0:15 Distal femoral fractures—management principles 16:00 16:15 0:15 Distal radial fractures—which to fix? How to fix?
17:05 17:20 0:15 Introduction to tibial plateau fractures 16:15 16:25 0:10 Q&A
17:20 17:35 0:15 Distal radial fractures—which to fix? How to fix? 16:25 16:45 0:20 Tea Break
Practical exercise 6

This practical exercise can be done with a dynamic hip

screw (DHS) or the TFN-Advanced proximal femoral nailing
system (TFNA). Please choose only one of the following
options:

1 demo for faculty demonstration

17:35 17:45 0:10 Q&A 16:45 17:45 1:00 Intramedullary fixation of a trochanteric fracture using the
TFN-Advanced proximal femoral nailing system (TFNA)
• Video: 20256
• Bone model: LD2220.01

Hands-on for participants

Management of a trochanteric fracture using a DHS
• New video: 00137
• Bone model: LD2220.01
Group A & B (Lecture room)
17:45 18:00 0:15 Summary of the day
DAY 3
Start End Duration Details Start End Duration Details
7:30 8:00 0:30 Registration 7:30 8:00 0:30 Registration
Group A Group B
Practical exercise 7:
Operate your plan—fixation of a 22C1 forearm fracture using the LCP 3.5 (8 and 11
8:00 9:00 1:00 8:00 8:15 0:15 Management of open fractures
holes)
• Bone model: 6501
9:00 9:15 0:15 Feedback on practicals 8:15 8:30 0:15 Principles of external fixation
9:15 9:30 0:15 Management of open fractures 8:30 8:45 0:15 Treatment algorithms for the polytrauma patient
9:30 9:45 0:15 Principles of external fixation 8:45 9:00 0:15 Emergency management of pelvic fractures—a critical skill can save lives
9:45 10:00 0:15 Treatment algorithms for the polytrauma patient 9:00 9:10 0:10 Q&A
10:00 10:15 0:15 Emergency management of pelvic fractures—a critical skill can save lives 9:10 9:25 0:15 Tea Break
Practical exercise 7:
Operate your plan—fixation of a 22C1 forearm fracture using the LCP 3.5 (8 and
10:15 10:25 0:10 Q&A 9:25 10:25 1:00
11 holes)
• Bone model: 6501
10:25 10:40 0:15 Tea Break 10:25 10:40 0:15 Feedback on practicals
Practical exercise 8
Application of a modular large external fixator
Please choose one of the following. Time permitting, a second exercise can be
Small group discussion 4:
performed (add an extra 30 minutes)
Final case discussion on selected topic:
• Video: 00116 (tibia modular external fixator)
10:40 12:10 1:30 10:40 11:50 1:10 • Polytrauma
• Bone model: 1111
• Complications
• Video: 00119 (ankle bridging modular external fixator)
• Special fractures, eg, geriatric fractures, osteoporosis, periprosthetic fractures
• Bone model: PR0535
• Video: 00120 (knee bridging modular external fixator)
• Bone model: PR0536
Practical exercise 9
Stabilization of the pelvic ring using a large external fixator
11:50 12:30 0:40 Lunch
• Video: 00122
• Bone model: 4083
Practical exercise 8
Application of a modular large external fixator
Please choose one of the following. Time permitting, a second exercise can be
Small group discussion 4:
performed (add an extra 30 minutes)
Final case discussion on selected topic:
• Video: 00116 (tibia modular external fixator)
12:10 13:20 1:10 • Polytrauma 12:30 14:00 1:30
• Bone model: 1111
• Complications
• Video: 00119 (ankle bridging modular external fixator)
• Special fractures, eg, geriatric fractures, osteoporosis, periprosthetic fractures
• Bone model: PR0535
• Video: 00120 (knee bridging modular external fixator)
• Bone model: PR0536
Practical exercise 9
Stabilization of the pelvic ring using a large external fixator
13:20 14:00 0:40 Lunch
• Video: 00122
• Bone model: 4083
Group A & B
14:00 14:15 0:15 Radiation in the operating room—appropriate use and hazards
14:15 14:30 0:15 Delayed healing—causes and treatment principles
14:30 14:45 0:15 Fracture-related infection—how to prevent, diagnose, and manage infections
14:45 15:00 0:15 Fractures in the growing skeleton—how are they different?
15:00 15:15 0:15 Fixation principles in osteoporotic bone—the geriatric patient
15:15 15:30 0:15 Future of fracture treament
15:30 15:45 0:15 Violation of principles
15:45 15:55 0:10 Closing remarks