LENGTH OF OPERATIVE PROCEDURES - REAMED FEMORAL INTRAMEDULLARY NAILING PERFORMED WITH AND WITHOUT A FRACTURE TABLE

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.