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

Abstract

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.