Duration of intraoperative fluoroscopy as a determinant of operative time in supracondylar femoral fracture treatment

Abstract

Introduction/Objective Supracondylar femoral fractures are relatively uncommon injuries which, owing to their specific characteristics, present a particular therapeutic challenge. Operative management is the gold standard for treatment. This study aims to analyse operative duration and intraoperative fluoroscopy time in patients treated with a condylar-type self-dynamizable internal fixator compared to a retrograde intramedullary nail for the femur, and to examine the association between these two parameters.

Methods The study included 66 patients, divided into two groups of 33 participants. Patients in the first group underwent treatment with a retrograde intramedullary nail, whereas those in the second group underwent fixation with a condylar-type self-dynamizable internal fixator. In both groups, operative time (in minutes) and fluoroscopy time (in seconds) were recorded.

Results The mean operative time in patients treated with a retrograde intramedullary nail was statistically significantly shorter than in those treated with the self-dynamizable internal fixator. Conversely, the mean fluoroscopy time was statistically significantly longer in the retrograde intramedullary nail group. Radiation exposure time was a significant predictor of operative duration.

Conclusion Operative duration is an important factor in planning the surgical schedule and the type of anaesthesia. As expected, operative time was shorter with a retrograde intramedullary nail than with a self-dynamizable internal fixator. Intraoperative fluoroscopy is standard practice in orthopaedic trauma surgery; therefore, continuous refinement of surgical technique is essential to minimise radiation exposure and protect the health of the surgical team. Intraoperative fluoroscopy time was shorter with the self-dynamizable internal fixator than with the retrograde intramedullary nail.

Keywords: self-dynamizable internal fixator; retrograde intramedullary nail; fluoroscopy; operative duration