Pr. Wolinsky et al., LENGTH OF OPERATIVE PROCEDURES - REAMED FEMORAL INTRAMEDULLARY NAILING PERFORMED WITH AND WITHOUT A FRACTURE TABLE, Journal of orthopaedic trauma, 12(7), 1998, pp. 485-495
Objectives: To determine whether performing reamed intramedullary nail
ing of the femur without the use of a fracture table decreases the len
gth of operation. Design: Retrospective. Setting: Level 1 trauma cente
r, Nashville, Tennessee. Patients/Participants: Consecutively treated
patients with fractures of the femoral shaft were treated with intrame
dullary nails from June 1986 to March 1996. Intervention: Reamed intra
medullary nailing of the femoral shaft was performed with the use of a
fracture table or with the leg draped free on a radiolucent table. Ma
in Outcome Measurements: Length of anesthesia time, prep and drape tim
e (from the point the anesthetized patient is turned over to the surge
ons until incision), and intramedullary nailing time (from incision un
til end of surgery) for reamed intramedullary nailing of the femoral s
haft performed with and without the use of a fracture table were compa
red. Results: Univariate analysis showed statistically significant dec
reases in the length of prep and drape time, operative time, and anest
hetic time when fractures were treated without the use of a fracture t
able. Multivariate analysis showed that use of a fracture table prolon
gs prep and drape time (plus twenty minutes), operative time (plus sev
enteen minutes), and anesthesia time (plus seventy-three minutes) when
the covariates of age, sex, fracture location, learning curve, positi
on of the patient, nail brand, and number of distal bolts are controll
ed. Conclusions: Reamed intramedullary nailing of the femoral shaft pe
rformed without the use of a fracture table is significantly faster th
an when the procedure is performed with a fracture table.