{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T06:46:19Z","timestamp":1779259579906,"version":"3.51.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["169995"],"award-info":[{"award-number":["169995"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Hamilton Academic Health Sciences Organization"},{"DOI":"10.13039\/501100021404","name":"Canadian Orthopaedic Trauma Society","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100021404","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To determine whether patient positioning supine on a fracture table (SFT) or laterally on a radiolucent table (LRT) reduced the risk of clinically important femoral malrotation in patients undergoing antegrade intramedullary fixation for femoral shaft fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A pilot, multicenter, prospective, cluster, randomized, crossover trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Three orthopaedic trauma centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>Patients older than 18 years with femoral shaft fractures (AO\/OTA 32-A, 32-B, or 32-C) appropriate for antegrade intramedullary fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures and Comparison:<\/jats:title>\n                    <jats:p>The primary clinical outcome was rotational alignment of the operative limb measured through a bilateral postoperative computed tomography scan, using the uninjured limb as a reference. Secondary clinical outcomes included quality of life, mobility, operative time, fluoroscopy use, need for open reduction, use of reduction adjuncts, associated positioning complications, hospital stay, and ventilator support days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 101 patients were enrolled, with 54 randomized to SFT and 47 randomized to LRT. There were 26 females (48.1%) in the SFT group and 27 females (57.4%) in the LRT group. The mean age was 60.2 years (SD 25.8 years) in the SFT group and 62.7 years (SD 27.6 years) in LRT group. Most fractures resulted from falls (59.3% SFT; 66% LRT), were subtrochanteric (63% SRT; 61.7% LRT), and classified as simple AO\/OTA 32-A (53.7% SRT; 53.2% LRT). Femoral malrotation &gt;15 degrees occurred in 20 SFT (37.7%) and 9 LRT (19.1%) participants The odds of femoral malrotation of \u226515 degrees were 2.6 times higher in the SFT group (95% confidence interval 1.0 to 6.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04). In both groups, patients were more likely to have an external rotation deformity compared with their native anatomy, with external rotation more common in SFT (69.8% vs. 59.6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.17). No secondary outcomes reached statistical significance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this clinical outcome assessment of patients enrolled in a feasibility trial, patients treated with SFT were more likely to have femoral malrotation after femoral shaft fracture fixation than those treated with LRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000003077","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T13:00:44Z","timestamp":1758286844000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Supine Positioning on the Fracture Table Versus Lateral Positioning for Antegrade Intramedullary Fixation of Femur Fractures (The Fracture Table Versus Lateral Positioning Study): The Clinical Outcomes of a Multicenter, Cluster, Randomized, Crossover, Pilot Study"],"prefix":"10.1097","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-1298","authenticated-orcid":false,"given":"Daniel E.","family":"Axelrod","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Sprague","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada;"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernesto","family":"Guerra-Farfan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, Barcelona, Spain;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaiza","family":"Garcia-Sanchez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, Barcelona, Spain;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad","family":"Meulenkamp","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Dodd-Moher","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; 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