Length of operative procedures: Reamed femoral intramedullary nailing performed with and without a fracture table

Objectives: To determine whether performing reamed intramedullary nailing of the femur without the use of a fracture table decreases the length of operation. Design: Retrospective. Setting: Level 1 trauma center, Nashville, Tennessee. Patients/Participants: Consecutively treated patients with fractures of the femoral shaft were treated with intramedullary nails from June 1986 to March 1996. Intervention: Reamed intramedullary nailing of the femoral shaft was performed with the use of a fracture table or with the leg draped free on a radiolucent table. Main Outcome Measurements: Length of anesthesia time, prep and drape time (from the point the anesthetized patient is turned over to the surgeons until incision), and intramedullary nailing time (from incision until end of surgery) for reamed intramedullary nailing of the femoral shaft performed with and without the use of a fracture table were compared. Results: Univariate analysis showed statistically significant decreases in the length of prep and drape time, operative time, and anesthetic time when fractures were treated without the use of a fracture table. Multivariate analysis showed that use of a fracture table prolongs prep and drape time (plus twenty minutes), operative time (plus seventeen minutes), and anesthesia time (plus seventy-three minutes) when the covariates of age, sex, fracture location, learning curve, position of the patient, nail brand, and number of distal bolts are controlled. Conclusions: Reamed intramedullary nailing of the femoral shaft performed without the use of a fracture table is significantly faster than when the procedure is performed with a fracture table.