Operative times of 7 common Orthopaedic Trauma procedures: is there a difference between trainees and consultants?

Surgical training in the UK is under increasing pressure with a high demand for service provision. This raises concerns about the resultant negative impact this is having on training opportunities for surgical trainees in theatre due to a high demand for surgical procedures to be performed expediently by consultants. This is due to the assumption that trainee take significantly longer time to operate in theatre and thus result in a slow progress of theatre lists.

We evaluated the differences in operative time between orthopaedic trainees and orthopaedic consultants, as well as provided realistic timings for each stage encompassed within the entire duration a patient is in theatre.

From our trauma unit electronic theatre database, we retrospectively collected data for six Joint Committee of Surgical Training (JCST) mandatory procedures. Information collected included patients' ASA grading, total surgical time and grade of surgeons.

A total of 956 procedures were reviewed, 71.8% hip procedures, 14.2% intramedullary nail fixations and 14.2% ankle fixations. 46.2% and 53.8% of the procedures were performed by consultants and trainees as first surgeon, respectively.

On average, consultants were found to be 13 minutes quicker in performing the hip procedures and this difference was found to be statistically significant (p < 0.05). However, trainees were found to be quicker in performing intramedullary femoral nailing and simple ankle fixations, but consultants were faster at performing intramedullary tibial nailing and complex ankle fixations. The differences were not found to be statistically significant (p > 0.05).