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AOTrauma Swiss Residents Course—Principles in Operative Fracture Management December 3–8, 2011 Davos, Switzerland Lecture hall: Davos
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Dear AOTrauma Course Participant We have the honour to welcome you to the AOTrauma Swiss Residents Course—Principles in Operative Fracture Management run by the AOTrauma Specialty! We hope you will enjoy your course and the entire experience. What is AOTrauma? We are the "clinical division"—a community for Trauma and Orthopaedics within the AO Foundation. As an AO Specialty we aim to integrate and align applied and clinical research, education, and community development functions into one direction—AOTrauma for the benefit of our members, stakeholders, and patients. How AOTrauma benefits you? By working as a single team we will focus and better leverage our resources, expertise, and skills on creating and delivering new and greater value to our members. What does this mean in education? AOTrauma is committed to provide you the best possible educational experience by continuously embracing and introducing new educational techniques to help you learn and more effectively implement your knowledge for the benefit of your patients. Why join AOTrauma? Joining AOTrauma means you are part of the “Trauma & Orthopaedic” community within the AO. AOTrauma will help you develop lifelong friendships and relationships; we will help you access our “knowledge network” and get involved in new opportunities that advance trauma care. Yours sincerely, Photo Photo Kodi Kojima Nikolaus Renner Chairperson AOTrauma Chairperson AOTrauma Education Commission International Board PS: Your experiences with us, over the next few days, will result in the realization of new and meaningful knowledge, skills, and understanding that we hope will translate into improved patient care.
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The first AO Course was held in Davos in 1960—these early courses pioneered psychomotor techniques by teaching practical skills of AO Techniques. Since those early days over 250,000 surgeons and 135,000 ORP staff from over 110 countries have attended AO Courses—we now launch AOTrauma to move our education to the next level.
Content Value statement The AO principles Dear AOTrauma course participant Goal of the course Target participants Course objectives Course description Chairpersons Faculty Saturday, December 3 2011 Sunday, December 4, 2011 Monday, December 5, 2011 Tuesday, December 6, 2011 Wednesday, December 7, 2011 Thursday, December 8, 2011 Course organization Course logistics Course information Course venue Business center Wireless network Exhibitions Transportation Sponsors Upcoming courses
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Goal of the course The AOTrauma Course for Swiss Residents is designed to provide the participants with basic treatment principles in operative management of the most common fractures based on the application of AO Principles.
Target participants Residents in their first to third year of training who intend to become specialized in general surgery or in orthopedic surgery in a Swiss hospital with a commitment to trauma.
Course objectives Upon completion of this course participants should be able to: • Demonstrate a basic knowledge of the biology of bone healing and define logical steps for surgical fracture
treatment. • Read and analyze the x-ray of a fracture properly and apply the Müller AO Classification system. • Recognize the relevance of proper preoperative analysis and planning. • Outline and apply the principles in the treatment of diaphyseal and articular fractures. • Apply the knowledge of soft-tissue injury in making the best decisions about treatment options and timing.
Course description Course participants will learn the basic AOTrauma Principles of fracture management and be trained in the techniques for the management of common fractures. Each module consists of a number of evidence-based lectures which cover the principle concepts recommended. In practical exercises participants will gain experience in the application of these techniques. These same concepts are expanded and reinforced in small group discussions emphasizing indications, options, applications, and developing a valid decision-making process.
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Online activities August 1, 2011 – January 31, 2012
Task 1 Online precourse self-assessment (August 1 – August 31)
Completion of eModules DLM 1 (September 1 until September 13)
DLM 2 (until September 27)
DLM 3 (until October 11)
DLM 4 (until October 25)
Completion of eModule on biology of bone healing (November 1 – November 29)
Task 2 Online postcourse self-assessment (January 10 - January 31, 2012)
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Chairpersons Photo Photo Mathieu Assal Thomas Hotz Genève, Switzerland Winterthur, Switzerland
Faculty Assal Mathieu Switzerland [email protected] Hotz Thomas Switzerland [email protected] Acklin Yves Switzerland [email protected] Arigoni Michele Switzerland [email protected] Borens Olivier Switzerland [email protected] Broger Ivan Switzerland [email protected] de Boer Piet Switzerland [email protected] Eid Karim Switzerland [email protected] Gautier Emanuel Switzerland [email protected] Helmy Näder Switzerland [email protected] Hess Rolf Switzerland [email protected] Hoffmeyer Pierre Switzerland [email protected] Jakob Marcel Switzerland [email protected] Kombot Cyril Switzerland [email protected] Lattmann Thomas Switzerland [email protected] Müller Thomas Simon Switzerland [email protected] Noger Markus Switzerland [email protected] Orler René Switzerland [email protected] Peter Robin Switzerland [email protected] Platz Andreas Switzerland [email protected] Rancan Mario Switzerland [email protected] Renner Nikolaus Switzerland [email protected] Rindlisbacher Andreas Switzerland [email protected] Rudin Mark Switzerland [email protected] Rüedi Thomas Switzerland [email protected] Schubiger Christoph Switzerland [email protected] Sommer Christoph Switzerland [email protected] Sprengel Kai Switzerland [email protected] Spycher Jonathan Switzerland [email protected] Stern Richard Switzerland [email protected] Sutter Paul Martin Switzerland [email protected] Thein Eric Switzerland [email protected] Winkler Jörg Switzerland [email protected]
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Saturday, December 3, 2011
TIME AGENDA ITEM WHO
15:00 Opening of the Convention Center
15:00-17:00 Registration of participants
17:00–18:00 Opening Ceremony
18:00–20:00 The Martin Allgöwer Reception
Sunday, December 4, 2011
TIME AGENDA ITEM WHO
08:00–08:15 Introduction: objectives, structure, faculty, summary drawing T Hotz, M Assal
The fracture—fracture healing, fracture analysis Upon completion of this module participants should be able to
- Know the Principles of fracture management - Understand bone and fracture healing processes - Accurately read a radiograph of a fracture - Classify any fracture according to the AO Classification
Moderator: T Hotz
08:15–08:30 Principles of fracture management—the patient and the injury N Renner
08:30–08:35 Questions and discussion
08:35–08:50 Bone/fracture healing—creating a healing environment N Renner
08:50–08:55 Questions and discussion
08:55–09:10 Read the x-ray E Gautier
09:10–09:15 Questions and discussion
09:15–09:30 AO Classification—why is this important? AO Surgery Reference—its value for your daily use
M Rancan
09:30–09:35 Questions and discussion
09:35–09:50 COFFEE BREAK
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09:50–09:55 Transfer to group discussions/hands-on parcours
09:55-10:55 Group A—Eyes and brain on 1: Read the x-ray Group 5 Group 6 Group 7 Group 8 Group 21 Group 22
10:55–11:05 Break
11:05-12:00 Group A—Eyes and brain on 2: Classification Group 5 Group 6 Group 7 Group 8 Group 21 Group 22
09:55–12:00 Group B—Hands-on parcours (Location Foyer C1) Groups 1, 2, 3, 4, 11, 12 Torque measurement Depth of perforation Temperature measurements Mechanics of bone fractures Fracture healing Techniques of reduction Mechanics of intramedullary nailing Mechanics of plate fixation 1 Mechanics of plate fixation 2 Difficult implant removal Mechanical quiz (optional)
12:00–16:00 LUNCH BREAK
Basic mechanics and concepts fixation Upon completion of this module participants should be able to
- Understand the mechanical concepts of fracture fixation - Perform an accurate preoperative plan - Know the principles of closed and open reduction
Moderator: M Assal
16:00–16:20 Mechanical concepts of fixation E Gautier
16:20–16:25 Questions and discussion
16:25–16:40 Preoperative planning—rationale and how to do it with PACS PM Sutter
16:40–16:45 Questions and discussion
16:45–17:00 Closed and open reduction—principles and techniques C Sommer
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17:00–17:05 Questions and discussion
17:05–17:25 COFFEE BREAK
17:25–17:30 Transfer to group discussions/hands-on parcours
17:30–18:30 Group B—Eyes and brain on 1: Read the x-ray Group 1 Group 2 Group 3 Group 4 Group 11 Group 12
18:30–18:40 Break
18:40–19:40 Group B—Eyes and brain on 2: Classification Group 1 Group 2 Group 3 Group 4 Group 11 Group 12
17:30–19:40 Group A—Hands-on parcours (Location Foyer C1) Groups 5, 6, 7, 8, 21, 22 Torque measurement Depth of perforation Temperature measurements Mechanics of bone fractures Fracture healing Techniques of reduction Mechanics of intramedullary nailing Mechanics of plate fixation 1 Mechanics of plate fixation 2 Difficult implant removal Mechanical quiz (optional)
19:40–19:45 Transfer to lecture hall
19:45–19:55 Talking to the expert (with cases) Expert: R Stern Moderator: M Assal
19:55–20:00 Closing of the day/poll
20:00 End of day 1 Faculty meeting (mandatory)
T Hotz
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Monday, December 5, 2011
TIME AGENDA ITEM WHO
Diaphyseal fractures 1—fixation concepts Upon completion of this module participants should be able to
- Understand the concepts of absolute and relative stability - Know the principles of conventional plate fixation, LCP, screw fixation
and intramedullary nailing
Moderator:
08:00–08:10 Summary of day 1 / Awake session A Platz
08:10–08:25 Principles of diaphyseal fractures management (rel./abs. stability, bone healing)
R Stern
08:25–08:30 Questions and discussion
08:30–08:45 Conventional plate fixation—biomechanics and techniques (direct-/ indirect healing, lag-/ set screw)
T Lattmann
08:45–08:50 Questions and discussion
08:50–09:05 Principles and concept of the locking compression plate (LCP) C Sommer
09:05–09:10 Questions and discussion
09:10–09:25 Intramedullary nailing for fracture treatment M Arigoni
09:25–09:30 Questions and discussion
09:30–09:45 COFFEE BREAK
09:50–10:00 10:00-11:00 11:00–12:00
Practical exercises 1: How to use a power drill Internal fixation with screws and plates providing absolute stability The principle of the internal fixator using the locking compression plate (LCP)
M Rudin T Lattmann C Sommer
12:00–16:00 LUNCH BREAK (POSSIBILITY FOR PLAY GROUND)
Diaphyseal fractures 2—femur, tibia, humerus, forearm Upon completion of this module participants should be able to
- Know the treatment options for femoral, tibial, humeral and forearm shaft fractures in particular intramedullary nailing
Moderator: C Sommer
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16:00–16:10 Treatment of femoral shaft fractures R Peter
16:10–16:15 Questions and discussion
16:15–16:25 Treatment of tibial shaft fractures (excl. MIPO) T Mueller
16:25–16:30 Questions and discussion
16:30–16:35 Transfer to practicals
16:35–17:45 Practical exercise 2: The cannulated femoral nail (CFN) and SynReam Coffee break included
J Spycher
17:45–17:55 Treatment of humeral shaft fractures P Hoffmeyer
17:55–18:00 Questions and discussion
18:00–18:10 Treatment of forearm shaft fractures O Borens
18:10–18:15 Questions and discussion
18:15–18:20 Transfer to practicals
18:20–19:40 Practical exercise 3: Management of a forearm shaft fracture 22-C1 using an LCP 3.5 (8 and 11 holes)
O Borens
19:40–19:45 Transfer to lecture hall
19:45–20:00 Talking to the expert (with cases) Expert: P Hoffmeyer Moderator: M. Assal
20:00 End of day 2 Faculty meeting (mandatory)
T Hotz
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Tuesday, December 6, 2011
TIME AGENDA ITEM WHO
Diaphyseal fractures 3—soft tissue and special problems Upon completion of this module participants should be able to
- Understand the principles of surgical approaches - Know the concept of Minimally Invasive Plate Osteosynthesis (MIPO) - Understand soft tissue management in open fractures
Moderator: R Peter
08:00–08:10 Summary of day 2 / Awake session M Arigoni
08:10–08:25 Principles of surgical approaches P de Boer
08:25–08:30 Questions and discussion
08:30-08:40 08:40-08:45
Minimally invasive plate osteosynthesis (MIPO) How I do it: MIPO distal tibia (with 3 min Video)
R Stern M Assal
08:45–08:50 Questions and discussion
08:50–09:05 Management of open fractures—skeleton, soft-tissue management M Jakob
09:05–09:10 Questions and discussion
09:10–09:15 Transfer to practicals
09:15–10:15 10:15–11:20
Practical exercises 4: Tibia shaft fracture—large external fixator: modular frame Coffee break included Tibia fractures—intramedullary nailing with the expert tibial nail (without reaming)
C Schubiger R Orler
11:20–11:35 Infection after osteosynthesis—how to diagnose and manage O Borens
11:35–11:40 Questions and discussion
11:40–11:55 Nonunions—treatment concepts R Stern
11:55–12:00 Questions and discussion
12:00–16:00 LUNCH BREAK (POSSIBILITY FOR PLAY GROUND/TRAINING GROUND 3 X EX 2 AND 3 X EX 3)
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Articular fractures 1—general problems Upon completion of this module participants should be able to
- Understand fixation concepts in articular fractures - Be familiar with surgical treatment of wrist fractures
Moderator: M Jakob
16:00–16:15 Fixation concepts in articular fractures J Winkler
16:15–16:20 Questions and discussion
16:20–16:25 Transfer to group discussions
16:25–17:35 Eyes and brain on 3: Articular fractures—radiographic analysis, classification, and treatment options Group 1 => room 1 Group 2 => room 2 Group 3 => room 3 Group 4 => room 4 Group 5 => room 9 Group 6 => room 10 Group 7 => room 13 Group 8 => room 14 Group 11 => room 11 Group 12 => room 12 Group 21 => room 21 Group 22 => room 22
17:35–17:55 COFFEE BREAK
17:55–18:10 Principles of the Treatment of wrist fractures A Platz
18:10–18:15 Questions and discussion
18:15–18:20 Transfer to practicals
18:20–19:25 Practical exercise 5: Management of a distal radial fracture by palmar plating with an LCP 2.4
T Hotz
19:25–19:30 Transfer to lecture hall
19:30–19:45 English Expert Performance
19:45–20:00 Questions and discussion
20:00 End of day 3
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Wednesday, December 7, 2011
TIME AGENDA ITEM WHO
Articular fractures 2—lower extremity Upon completion of this module participants should be able to
- Understand treatment concepts for per- and intertrochanteric fractures and distal femoral fractures
- Know when to fix and when to replace (arthroplasty) femoral neck fractures
Moderator: N Renner
08:00–08:10 Summary of day 3 / Awake session O Borens
08:10–08:25 Per- and Intertrochanteric femoral fractures—treatment concepts T Hotz
08:25–08:30 Questions and discussion
08:30–08:35 Transfer to practicals
08:35–09:50 Practical exercise 6: Trochanteric femoral fracture— intramedullary nailing with the PFNA Coffee break included
T Hotz
09:50–10:05 Distal femoral fractures—treatment concepts C Schubiger
10:05–10:10 Questions and discussion
10:10–10:25 Femoral neck fractures—when to fix, when to replace R Hess
10:25–10:30 Questions and discussion
10:30–10:35 Transfer to practicals
10:35–11:10 11:10–12:00
Practical exercises 7: Management of a femoral neck fracture using the 7.3 mm cannulated screw Dynamic hip screw (DHS)
R Hess J Winkler
12:00–16:00 LUNCH BREAK (POSSIBILITY FOR PLAY GROUND/TRAINING GROUND 3 X EX 5 AND 3 X EX 6)
Articular fractures 3—lower extremity Upon completion of this module participants should be able to
- Understand treatment strategies in tibia plateau fractures - Differentiate between the various types of malleolar fractures and their
fixation algorithm - Understand pilon fractures and the soft tissues challenge - Know how to diagnose, classify, and treat hind- and midfoot fractures
Moderator: A Platz
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16:00–16:15 Tibia plateau fractures, is it still a problem, even with better strategy antd implants?
M Noger
16:15–16:20 Questions and discussion
16:20–16:35 Malleolar fractures, a logical approach and how to fix them K Sprengel
16:35–16:40 Questions and discussion
16:40–16:45 Transfer to practicals
16:45–17:45 17:45–19:00
Practical exercises 8: Type B malleolar fracture Type C malleolar fracture Coffee break included
K Sprengel PM Sutter
19:00–19:15 Pilon fractures and how to avoid soft tissue problems C. Sommer
19:15–19:20 Questions and discussion
19:20–19:30
Talus and calcaneus fractures
M. Assal
19:30–19:40 Midfoot-/Lisfranc injuries M. Assal
19:40–19:45 Questions and discussion
19:45-20:00 AO principles and philosophy
P de Boer
20:00 End of the day Faculty meeting (mandatory)
T Hotz
Thursday, December 8, 2011
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TIME AGENDA ITEM WHO
Articular fractures 4—upper extremity Upon completion of this module participants should be able to
- Understand treatment options (non operative versus operative) for humeral shaft fractures
- Know how to treat distal humeral fractures Understand the treatment concept of tension band wiring for patellar and olecranon fractures as well as their other treatment options
Moderator: J Winkler
08:25–08:30 Questions and discussion
08:30–08:35 Transfer to practicals
08:35–09:40 Practical exercise 9: Fixation of a fracture in the proximal humerus using the PHILOS plate (proximal humerus internal locking system)
Y Acklin
09:40–09:55 Internal fixation of distal humeral fractures I Broger
09:55–10:00 Questions and discussion
10:00–10:20 COFFEE BREAK
10:20–10:35 Treatment of olecranon and patella fractures (tension band vs screws and plates)
M Rudin
10:35–10:45 Questions and discussion
10:45–10:50 Transfer to practicals
10:50–11:20 11:20–12:00
Practical exercises 10: Olecranon—transverse fracture 21-B1 managed by tension band wiring Olecranon—transverse fracture managed with plate osteosynthesis (3.5 mm) At the entrance to practicals: Demo pelvis with c-clamp and pelvis with Ex. Fix
A Platz T Hotz
12:00–12:45 LUNCH BREAK (lunch will be provided at the Convention Center)
Damage control orthopedics, problems, and solutions Moderator M Assal
12:45–13:00 General concepts of external fixation in damage control orthopedics (incl. T-pod, pelvic clamp, ext. fix. Pelvis)
R Peter
13:00–13:05 Questions and discussion
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13:05–13:35 T Ruedi
13:35–14:05 Self-test, prize giving A Platz
14:05–14:50 Summary of the week, prize giving T Hotz
14:50–15:00 Evaluation of the course and closing remarks T Hotz
15:00 End of the course
18:45–19:00 Transfer hotels to Congress Center
19:00–23:00 BANQUET
23:00–23:30 Transfer Congress Center to hotels
Course organization AOTrauma Claudia Güntensperger Clavadelerstrasse 8 7270 Davos, Switzerland Phone +41 81 414 27 20 Fax +41 81 414 22 84 Email [email protected]
Course logistics Industrial Partner Synthes GmbH Glutz-Blotzheim-Strasse 3 4500 Solothurn, Switzerland Phone +41 32 720 42 25 Fax +41 32 720 46 89 Website www.synthes.com
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Course information Course fee AOTrauma Swiss Residents Course—Principles in Operative Fracture Management CHF 1200. Included in course fee are conference bag with documentation, coffee breaks, cocktail reception, course certificate. Accreditation AOTrauma Courses are accredited for continuing medical education (CME) programs. The number of credit points or hours varies from country to country. The final information and number of credit points will be distributed with the course certificate. Evaluation guidelines All AOTrauma courses apply the same evaluation process, either ARS (audience response system) or paper & pencil questionnaires. This will help AOTrauma to ensure that we continue to meet your training needs. In some regions, CME accreditation is dependent on the participant’s evaluation results. Intellectual property Course materials, presentations, and case studies are the intellectual property of the course faculty. All rights are reserved. Check hazards and legal restrictions on www.aotrauma.org/legal. Recording, photographing, or copying of lectures, practical exercises, case discussions, or any course materials is strictly forbidden. Participants violating intellectual property will be dismissed.
Security Security check at the entrance of the building. Wearing of a name tag is compulsory during lectures, workshops, and group discussions. No insurance The course organization does not take out insurance to cover any individual against accidents, thefts or other risks. Mobile phone use Mobile phone use is not allowed in the lecture halls and in other rooms during educational activities. Please be considerate of others by turning off your mobile phone. Dress code Course: casual or sportswear Banquet: formal Davos is a mountain resort. Warm clothes and suitable shoes are advisable. Banquet Thursday, 19:00 at the Convention Center Banquet cards can be purchased/returned at the information desk until Monday evening. After this time reimbursement is no longer possible. A bus will pick you up at 18:45. Please see “Bus meeting points for the banquet”. Hotels Participants who have not booked a package including hotel should settle their hotel bill directly when checking out. HRG travel office The HRG travel office will support you with flight confirmation or re-booking during coffee break.
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Course venue Convention Center Davos Promenade 92 7270 Davos, Switzerland Phone +41 81 414 64 07 Fax +41 81 414 64 26 Welcome desk–opening hours General information/Registration for special events Sunday 15:00–17:00 Monday to Friday 07:45–19:00 Information/Faculty desk–opening hours Course information for Faculty and participants Sunday 15:00–17:00 Monday to Friday 07:30–19:00
Business center There is one business center in the Convention Center which is accessible to everybody. Services • Internet and e-mail access • Printing possibility • www.aotrauma.org
AO Course website offering course-related information. Location On floor A2 Opening hours 30 minutes before the first course of the day starts until 30 minutes after the last course ends Disclaimer The use of your own computer in the business center network is inherently not secure. We strongly recommend that you take appropriate actions to protect your computer against unauthorized use or theft (eg, Firewall, VPN-Connection, VirusScanner, etc). AO cannot be held responsible for any data loss or theft. For further information or support please contact: AO Foundation Phone +41 81 414 28 70 E-mail [email protected]
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Wireless network A special wireless network is accessible and free for everybody. Services • Internet and e-mail access • www.aotrauma.org
AO Course website offering course-related information. Locations At public places in the Convention Center
Exhibitions AO World Visit the AO World in the main foyer, home of the new world of the AO Specialties: AOTrauma, AOSpine, AOCMF; and AOVET. At the specialty exhibits you can explore membership opportunities, the award winning Surgery Reference, examine our print and electronic publications, learn about the ground-breaking activities occurring within AO, and discover the research, development, fellowship, and other opportunities available to you. You can also visit with the Clinical Investigation and Documentation (CID), the AO Research Institute Davos, the TK Office and AO GCTM. Come on into the AO World and sign up to become eligible for terrific prizes, including an exquisite Bucherer watch, and an iPod. Industry exhibitions Visit our industry partner Synthes as well as a number of industry providers who will demonstrate the latest advances in their technologies: BrainLab, Siemens, Mathys Orthopädie, Storz, Synbone, AMTS, Eli Lilly
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Transportation Special bus for course participants Sunday to Thursday 11:50/12:15 Convention Center–Mountain Railways 15:35 Mountain Railways–Convention Center Tuesday 12:20 Convention Center–AO Center 13:30 AO Center–Convention Center Wednesday 12:30 Convention Center–AO Center 13:30 AO Center–Convention Center Thursday 18:45 Hotels–Convention Center from 23:00 Convention Center–Hotels Local buses run every 10 minutes during the day. Bus meeting points for the banquet • Flüela (Bünda, Victoria) • Seehof (Parsenn) • Meierhof (Solaria, Zauberberg) • Dischma (Cresta, Edelweiss, Sonnenberg) • Belvédère (Panorama) • Central • Schweizerhof (Europe) • Posthotel (ArtHaus) • National (Esplanade, Strela) • Sunstar Park (Club Hotel) • Grischa (Larix)
Sponsors We would like to thank our partner Synthes for their support without which this event would not be possible. A special thanks to our main sponsor: Siemens We also extend our thanks to the following co-sponsors: BrainLab Credit Suisse Synbone Storz
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AO Courses—Davos 2012 AO Course–December 1 to 6, 2012 • AOTrauma Swiss Residents Course—Principles in Operative Fracture Management • AOTrauma Fortgeschrittenen-Kurs für operative Frakturbehandlung • AOTrauma Current Concepts Course • AOTrauma Course—Foot and Ankle • AOTrauma Course—Fragility Fractures and Orthogeriatric Comanagement • AOCMF Course-Principles in Craniomaxillofacial Fracture Management • AOVET Courses
AO Course–December 9 to 14, 2012 • AOTrauma Course—Principles in Operative Fracture Management • AOTrauma Course—Advances in Operative Fracture Management • AOTrauma Course—Masters • AOTrauma Course—Polytrauma • AOSpine Courses
List subject to changes. The final Davos courses as well as worldwide courses lists will be available on www.aotrauma.org in January 2012.
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