Effects of Gamification on Surgical Duration and Outcomes in Patients Undergoing Fixation of Intertrochanteric Hip Fractures

Objective: To compare surgical duration and clinical outcomes with associated complications in surgeons using gamification techniques for resident education versus those surgeons who do not. Design: Retrospective, cohort study. Level III evidence. Surgical interventions included long cephalomedullary nailing with gamification techniques compared to long cephalomedullary nailing alone. Main outcome measurements were total fluoroscopy time, operative time, hospital length of stay, discharge status, and complications. Setting: Urban Level 1 Trauma Center. Participants: One fourty-eight adult patients with operative intertrochanteric femur fractures from January 2010 to January 2019. Results: There were lower total operative times (45.6 vs. 57.1 minutes, p =< 0.01) and fluoroscopy times (1.6 vs. 2.1 minutes, p = 0.01) in the gamification group. There were no significant differences between groups in patient demographics, fracture pattern, postoperative complications, length of hospital stay, total follow-up, total ICU stay time, or discharge to extended care facility versus home. Conclusions: Gamification techniques with use of long cephalomedullary nails are a valid approach to the treatment of intertrochanteric femur fractures. This approach demonstrates equivalent outcomes postoperatively to nongamification treatment of intertrochanteric femur fractures, with the potential advantage of decreased operative and fluoroscopic times.