[INCORPORATING INTRAOPERATIVE DIGITALIZATION SOFTWARE IN ORTHOPEDIC TRAUMA: REDUCING OPERATIVE TIME IN PERTROCHANTERIC FRACTURE FIXATION].

INTRODUCTION

Integration of an intraoperative digitalization tool aims to improve daily work in the operating room by improving communication between staff members, patient safety and creating a database for future research.

AIMS: To evaluate the effect of intraoperative digitalization tools on total operative time, procedure standardization and fluoroscopy use.

METHODS

This retrospective study examined patients with pertrochanteric fracture, treated with closed reduction and internal fixation with a short cephalomedullary nail using the Proximal Femoral Nailing System (TFNA). The surgical protocol was displayed on a screen and controlled by a foot pedal. The data collected included the total surgical time and the amount of radiation emitted in millisievert (mSv). The cases were divided into four groups in a chronological fashion according to yearly quarters. The total operative time was compared to the literature.

RESULTS

Sixty operations were performed, forty-four by competent surgeons and 16 by expert surgeons. The average procedure time was 59.66 minutes. A decrease in operative time was observed for all surgeons (reduction of 2.27 minutes per month, p=0.0232, and reduction of 1.71 minutes per month, p=0.0093, for expert and competent surgeons, respectively). No difference was observed after standardization (p=0.201). Average operative time of group 4, which included the cases operated during the latest period (n=15) was 42.37 minutes, below the value accepted in the literature of 60.62 minutes (p=0.00117). Fluoroscopy use averaged 7.14 mSv, showing no change (p=0.414).

CONCLUSIONS

Although digitalization led to decreased operative time, no improvement was observed after standardization. This was attributed to the small sample size.

DISCUSSION: Implementation of an intraoperative digitalization tool showed reduction in operative time for all surgeons, with no reduction in the use of fluoroscopy.