At the touch of a finger

 New OSapp interactively illustrates biomechanical concepts’ relationship to fracture fixation principles

02 December 2020

Globally renowned for education excellence, the AO builds on its innovation legacy with strategy fund support for a new, interactive, virtual osteosynthesis software tool and learning platform: OSapp. The application, aimed at fostering understanding of the biomechanical concepts underlying the principles of fracture fixation, is being launched globally at the AO Davos Courses 2020.

The OSapp project grew out of a post-course discussion between AO Research Institute Davos (ARI) Biomechanics and Modeling Focus Area Leader Peter Varga, PhD, and AO Technical Commission Upper Extremity Global Expert Committee Chair and longtime AO Trauma faculty member Simon Lambert, MD.

“I participated in an AO masters course group discussion at the AO Davos Courses 2018. During one session, Lambert gave a crash course on the principles of plating, with a reminder about the biomechanical principles behind it,” Varga recalls. “It seemed to me that there was a gap in participants’ understanding of the biomechanical concepts underlying the principles of fracture fixation. I mentioned this to Lambert after the course and he said: ‘Yes, that is apparently the case.”

The wheels in Varga’s head immediately began to spin. “I said it would be great to have a tool that could act as an interactive reminder about these biomechanical concepts and illustrate the principles of fracture fixation, and Lambert agreed. That’s how OSapp began,” says Varga. “We are developing an online available, attractive, easy to use, informative tool that draws users in, and we saw that even in its earliest, very crude pilot form, people showed interest playing with fracture fixations in the app.”

Lambert, who has 35 years of clinical experience, 100-plus peer-reviewed publications, and 20 book chapters, including a revision of Gray’s Anatomy chapters on the shoulder girdle and shoulder joint, famously uses drawings to illustrate biomechanical concepts and fracture fixation principles when he teaches, and Varga immediately grasped their educational potential.

Varga asked: "Could we convert your diagrams into a form that people could experiment with in order to better understand these biomechanical concepts underlying the principles of fracture fixation?” Lambert recounts, emphasizing the importance of a thorough understanding of those concepts and principles. “I learned very quickly how important it is to have the principles—rather than a recipe for fixation—within your grasp.”

With initial support from ARI, the project team created a virtual interactive environment where users can experiment with various scenarios and immediately understand the outcomes of their decisions—and that powers learning. AO founding father and senior scientific advisor Prof Stephan Perren played a valuable advisory role in aiding its development until few days before he passed away in November 2019. An off-line pilot version of OSapp was demonstrated at the AO Davos Courses 2019 and encouraged by experts’ enthusiastic feedback, Varga and Lambert approached the AO Innovation Translation Center (AO ITC) for strategy fund support.

The interactive nature of the app cannot be underestimated, Lambert says: "Many contemporary surgeons are digital natives, having grown up with computers, mobile phones, and video games, so it’s only natural that medical education tools evolve with their needs."

“Today, people are brought up with video games involving risk taking, problem solving, and hand-eye coordination, all of which have a sort of subliminal effect on the way they think,” he says. “If you have good hand-eye and triangulation coordination, you can do a lot of modern orthopedic surgery very well, but you do need a three-dimensional construct ability, which is where 3D image guidance and game play come together to form the basis of OSapp.”

The clinical relevance of the content is ensured by the guidance of the renown experts Reto Babst, Florian Gebhard, Martin Jaeger, Simon Lambert, and Michael Schuetz, constituting the Medical Advisory Board of the project.

OSapp project leaders Varga and Lambert envision a world of possibilities for the tool, including integration with other AO platforms, such as MyAO, the AO Surgery Reference and the digital version of the AO Principles of Fracture Management, and integration of a customized module for the AO Trauma Competency-based Training and Assessment Program (CTAP).

“Our short-term focus now is on the launch of the first version of the OSapp web application and getting as much feedback as possible during online testing at the AO Davos Courses 2020”, Varga adds.

From December 3, 2020 you can register here for free and test OSapp.

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