Fracture fixation procedures typically require precise retraction of soft tissues in order to provide adequate exposure of bone fragments for reduction and fixation. Such procedures require the use of multiple surgical assistants to maintain proper tissue retraction. This manual retraction using traditional instruments, such as Hohmann and Weitlaner retractors, can lead to inefficiencies and poor labor allocation within the operating room (OR). The purpose therefore is to develop and evaluate a three dimensional (3D)-printed Nylon PA12 adapter designed to dock Hohmann retractors onto Weitlaner retractors, enabling hands-free retraction during fracture fixation procedures and potentially improving labor allocation in the OR. We hypothesized that a modular adapter would improve retraction stability and reduce manual assistance compared to standard retraction methods. To evaluate this, twenty-seven orthopaedic surgeons, fellows and residents completed standardized simulation sessions comparing traditional manual retraction with adapter-assisted retraction and completed an anonymous questionnaire assessing usability, stability, confidence, and perceived impact on visualization. All participants reported improved retraction stability with adapter use, and 88.0% rated ease of use as ≥8 on a 10-point scale. High confidence in the adapter’s ability to maintain retraction was reported by 83.0% of users, and 67.0% reported improved visualization of the surgical field. Therefore, based on this single-site study, the developed low-cost, modular 3D-printed retraction adapter improved perceived stability and usability while integrating with standard orthopaedic instrumentation.
