Advanced Simulation System for Orbitozygomatic Fracture Reconstruction: Multicenter Validation of a Novel Training and Objective Assessment Platform.

Abstract

Orbitozygomatic fractures represent a complex surgical challenge. Given the urgent need for validated educational tools that surpass traditional learning models, this multicenter study developed and validated a novel synthetic advanced simulation model for the reconstruction of these fractures. The model integrates platinum-cured silicones and 3D-printed bony structures with prefabricated fractures, accurately replicating the anatomy and tactile properties of soft and hard tissues, including simulated herniation of orbital contents. To our knowledge, it is the only available synthetic model combining both tissue types for this training. Ten participants (faculty and residents) completed simulated procedures. Technical performance was assessed using a hand motion tracking system, the global OSATS (Objective Structured Assessment of Technical Skills) scale, and a task-specific error measurement (Specific Fault Measurement, SFM) scale. Statistically significant differences (p = 0.021) were observed in operative time and error count between novices and experts, confirming the model's construct validity. Faculty completed the surgery in significantly less time (mean 18.16 min vs. 37.01 min for residents) and made fewer errors (mean 12.25 vs. 53.25). Face and content validity were strongly supported by participant surveys, with 100% stating they would use the simulator to practice before real surgery. A strong inverse correlation (r = -0.786, p = 0.021) between OSATS and SFM scores demonstrated concurrent validity. This model enables ethical, repeatable, and cost-effective training, supporting its implementation into surgical curricula to enhance competence and provide objective skill assessment in orbitozygomatic trauma surgery.