The Development and Validation of CranioFix: An Augmented-Reality Biomodel for Craniomaxillofacial Education.

Objective: To describe the development, implementation, and validation of CranioFix, an augmented-reality (AR)-enhanced educational toolkit for the training of craniomaxillofacial trauma management, specifically orbit-zygomatic complex (OZC) fractures.

Background: Surgical training in craniomaxillofacial trauma presents significant challenges due to the complexity of the anatomy, limited exposure to trauma cases, and the need for hands-on technical skill acquisition. Augmented-reality simulation technologies offer a promising solution to these limitations.

Methods: CranioFix was developed as a hybrid AR and physical simulation model consisting of a 3D-printed skull with realistic tissue overlays, integrated surgical instruments, and a smartphone-based AR application. The app provides guided surgical instruction, anatomic overlays, and self-assessment tools. A validation study involving 15 surgeons and surgical trainees was conducted in a war-zone mission setting.

Results: Participants reported significant improvement in confidence levels for OZC trauma management (mean precourse 3.2/10 versus postcourse 6.3/10). The educational content received high ratings for usefulness (9.1/10), interactivity (8.3/10), and overall design (8.2/10). All participants endorsed CranioFix as a valuable training tool and recommended its expansion to other craniofacial procedures.

Conclusion: CranioFix is an effective, portable, and scalable AR-based simulation platform that enhances surgical training in craniomaxillofacial trauma. It is particularly valuable in resource-constrained or disrupted settings and has the potential for wide application in global surgical education.