Assessment of technical competence in anterolateral buttress plate fixation of tibial plateau fractures: a global Delphi consensus study

PURPOSE: Tibial plateau fractures often require surgery, where surgeon competence is critical. Competency-based medical education requires valid objective assessment. The purpose of this study was to develop an expert consensus-based, procedure-specific assessment tool to evaluate technical competence in buttress plate fixation of tibial plateau fractures. METHODS: International orthopaedic trauma educators participated in a four round online Delphi process to establish consensus on the content of the assessment tool. Round 1 identified potential parameters; Round 2 rated importance of each parameter; Round 3 addressed items outside this manuscript; Round 4 assigned weights (1–10). RESULTS: Eighty-seven surgeons from 42 countries participated. Of 31 parameters identified, five were excluded in Round 2, leaving 26. Parameter weights ranged from 6.8 to 9.6, with anatomical fracture reduction rated highest. CONCLUSION: The resulting consensus-based assessment tool shows strong content validity and supports structured feedback for formative and summative use in surgical training.