Make and Break Your Own Hand: A Review of Hand Anatomy and Common Injuries

AUDIENCE: The target audience for this small group session is emergency medicine residents, primarily for use in didactic conference. This session can also be utilized with medical students, or faculty looking to review relevant hand anatomy and common injuries. INTRODUCTION: Three-dimensional (3D) printing is an emerging technology that has the ability to produce highly accurate anatomic, cellular and medical device models. Limited research has shown promise in teaching anatomy,1 congenital heart disease2 and surgical pre-operative planning.3 Despite this potential, there is sparse evidence of 3D printing emergency medicine residency education. The Model of Clinical Practice of Emergency Medicine specifies content for American Board of Emergency Medicine certification and requires proficiency in a wide breadth of medical topics including upper extremity and hand injuries.4 The concepts of hand anatomy and function rely heavily on understanding spatial relationships between bones, tendons and ligaments. The instructional strategy of working with 3D printed hand models aligns with these learning goals. This project seeks to directly incorporate 3D printing into the orthopedic curriculum of emergency medicine residents during a required weekly didactic educational session. EDUCATIONAL OBJECTIVES: By the end of this session, learners should be able to name and identify all bones of the hand; arrange and construct an anatomically correct bony model of the hand; build functional phalangeal flexor and extensor tendon complexes onto a bony hand model; describe the mechanism of injury, exam findings, and management of the tendon injuries Jersey finger, Mallet finger, and central slip rupture; draw/recreate injury patterns on a bony hand model; and describe the mechanism of injury, exam findings, imaging findings, and management of scapholunate dissociation, perilunate dislocation and lunate dislocation, Bennett’s fracture, Rolando fracture, Boxer’s fracture and scaphoid. EDUCATIONAL METHODS: This session was delivered in a small group session which utilized educational methods grounded in constructivist learning such as complex problem-solving, social negotiation, and spatial learning. RESEARCH METHODS: Verbal feedback was obtained after the session. RESULTS: Overall learners found the session engaging, interactive, and especially useful in demonstrating relevant hand anatomy and injuries. Learners felt that hands-on experience with the hand models reinforced knowledge and helped them better identify injuries in a spatial fashion. TOPICS: Extremity bony trauma, dislocations/subluxations, tendon injuries.