Abstract
Background: Reamed intramedullary nailing is the current gold standard for the treatment of diaphyseal fractures of the femur and tibia. Current concepts of orthopedic damage control surgery for patients with multiple injuries have placed an emphasis on appropriate surgical timing, limiting blood loss, and the duration of the initial operative procedure(s). Proponents of unreamed nailing have stated that reaming places polytraumatized patients "at risk," in part because it adds to the length of the surgical procedure and may exacerbate the severity of a patient's pulmonary injury. The purpose of this study was to determine how many minutes reaming actually takes and what percentage of operative time reaming comprises during intramedullary nailing of femoral and tibial shaft fractures. Methods: Intraoperative timing data were collected prospectively on a total of 52 patients with 54 fractures (21 femoral and 33 tibial) who underwent reamed intramedullary nailing of acute closed or open femoral or tibial shaft fractures over a 10-month period. Total operating room, surgical, and reaming times were collected. Results: The average reaming time for femur and tibia fractures was 6.9 minutes and 7 minutes, respectively. On average, reaming accounted for 4.9% of the surgical time and 3.2% of the total operating room time for femur fractures and 4.9% of the surgical time and 3.4% of the total operating room for tibia fractures. Conclusion: Our results show that reaming comprises a small percentage of the operative time and the total time a patient spends in the operating room.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 727-734 |
| Number of pages | 8 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 67 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 2009 |
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Keywords
- Intramedullary nailing femur fractures
- Reaming
- Tibial fractures
ASJC Scopus subject areas
- Surgery
- Critical Care and Intensive Care Medicine
Cite this
Reaming does not add significant time to intramedullary nailing of diaphyseal fractures of the tibia and femur. / Crist, Brett D.; Wolinsky, Philip R.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 67, No. 4, 10.2009, p. 727-734.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reaming does not add significant time to intramedullary nailing of diaphyseal fractures of the tibia and femur
AU - Crist, Brett D.
AU - Wolinsky, Philip R
PY - 2009/10
Y1 - 2009/10
N2 - Background: Reamed intramedullary nailing is the current gold standard for the treatment of diaphyseal fractures of the femur and tibia. Current concepts of orthopedic damage control surgery for patients with multiple injuries have placed an emphasis on appropriate surgical timing, limiting blood loss, and the duration of the initial operative procedure(s). Proponents of unreamed nailing have stated that reaming places polytraumatized patients "at risk," in part because it adds to the length of the surgical procedure and may exacerbate the severity of a patient's pulmonary injury. The purpose of this study was to determine how many minutes reaming actually takes and what percentage of operative time reaming comprises during intramedullary nailing of femoral and tibial shaft fractures. Methods: Intraoperative timing data were collected prospectively on a total of 52 patients with 54 fractures (21 femoral and 33 tibial) who underwent reamed intramedullary nailing of acute closed or open femoral or tibial shaft fractures over a 10-month period. Total operating room, surgical, and reaming times were collected. Results: The average reaming time for femur and tibia fractures was 6.9 minutes and 7 minutes, respectively. On average, reaming accounted for 4.9% of the surgical time and 3.2% of the total operating room time for femur fractures and 4.9% of the surgical time and 3.4% of the total operating room for tibia fractures. Conclusion: Our results show that reaming comprises a small percentage of the operative time and the total time a patient spends in the operating room.
AB - Background: Reamed intramedullary nailing is the current gold standard for the treatment of diaphyseal fractures of the femur and tibia. Current concepts of orthopedic damage control surgery for patients with multiple injuries have placed an emphasis on appropriate surgical timing, limiting blood loss, and the duration of the initial operative procedure(s). Proponents of unreamed nailing have stated that reaming places polytraumatized patients "at risk," in part because it adds to the length of the surgical procedure and may exacerbate the severity of a patient's pulmonary injury. The purpose of this study was to determine how many minutes reaming actually takes and what percentage of operative time reaming comprises during intramedullary nailing of femoral and tibial shaft fractures. Methods: Intraoperative timing data were collected prospectively on a total of 52 patients with 54 fractures (21 femoral and 33 tibial) who underwent reamed intramedullary nailing of acute closed or open femoral or tibial shaft fractures over a 10-month period. Total operating room, surgical, and reaming times were collected. Results: The average reaming time for femur and tibia fractures was 6.9 minutes and 7 minutes, respectively. On average, reaming accounted for 4.9% of the surgical time and 3.2% of the total operating room time for femur fractures and 4.9% of the surgical time and 3.4% of the total operating room for tibia fractures. Conclusion: Our results show that reaming comprises a small percentage of the operative time and the total time a patient spends in the operating room.
KW - Intramedullary nailing femur fractures
KW - Reaming
KW - Tibial fractures
UR - http://www.scopus.com/inward/record.url?scp=72449178450&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=72449178450&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e31819db55c
DO - 10.1097/TA.0b013e31819db55c
M3 - Article
C2 - 19820578
AN - SCOPUS:72449178450
VL - 67
SP - 727
EP - 734
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 4
ER -