FRACTAL

An Engineering Approach to Fracture Management

The philosophy underpinning this lecture series is rooted in the confluence of engineering principles and orthopaedic surgery. It emphasizes the necessity of a understanding of mechanics, stress analysis, and material properties to effectively understand and manage fractures. The iterative process of construct design and the application of biomechanical constraints are not merely technical procedures but are seen as an intellectual framework. This approach champions a standardized methodology for analysing complex systems while remaining open to feedback loops, peer collaboration, and innovative technologies. Ultimately, it seeks to refine surgical techniques through a fusion of empirical rigor and creative adaptation, embodying a philosophy that values precision, continuous learning, and the melding of theory with practical application for improved patient outcomes.

The FRACTAL Algorithm

The FRACTAL algorithm is a structured, analytical framework designed to simplify the comprehension and resolution of mechanical challenges encountered in orthopaedic surgery. It delineates a methodical pathway for the visualization, dissection, and strategic management of complex mechanical problems. Below is an summary of each phase:

• Frame: Establish a simplified model by delineating the system's boundaries, defining relevant constraints, and selecting an appropriate coordinate system to contextualize forces and moments within a free body diagram.
• Resolve: Decompose force vectors into orthogonal components relative to the chosen frame of reference. This facilitates a granular examination of individual force magnitudes and directions, simplifying subsequent analysis.
• Anticipate: Employ predictive modeling based on classical mechanics, leveraging Newtonian dynamics and Hookean elasticity, to forecast system behavior under specified loading conditions.
• Constrain: Convert mechanical theory into tangible interventions by building mechanical constraints that counteract deforming forces. This involves strategic hardware selection and precise application to stabilize anatomic structures.
• Test: Conduct thought experiments to simulate extreme load scenarios. This stress-testing accentuates potential vulnerabilities within the construct, guiding preemptive optimization.
• Assess: Critically evaluate the engineered solution against established mechanical principles, scrutinizing stress distribution, material properties, and potential failure modes such as fatigue and crack propagation.
• Loop: Re-enter the construct into the FRACTAL cycle for iterative analysis. This recursive process ensures continuous improvement through empirical validation and adaptation to emerging data or clinical outcomes.

ATC Course Format

Commencing it's second season in April 2024, the series is composed of eight 60-minute lectures continuing weekly in an interactive format via Zoom. This 'ATC' Course is specifically designed for Advanced Trainees and Consultants, and assumes a high degree of surgical prerequisite knowledge. Each lecture is designed to be a comprehensive exploration of the themes identified in that week's curriculum. Attendees will have the unique opportunity to participate in these lectures live, fostering real-time engagement and interaction with the presenter and peers. Furthermore, for flexibility, each lecture will be recorded and made available for online streaming for a limited period following the course. This allows participants the option to schedule around work commitments or revisit complex topics at their convenience. To facilitate participant preparedness, pertinent pre-reading and supplementary materials will be made available prior to each session. This ensures everyone arrives with a foundational understanding, ready to engage in the more intricate discussions that form the backbone of the series.