Video‐augmented fluoroscopy for distal interlocking of intramedullary nails decreased radiation exposure and surgical time in a bovine cadaveric setting

A magnetic targeting device was developed to assist orthopedic surgeon’s with distal interlocking of intramedullary nails, in which the novel device aligns the surgeon’s drill at the correct location for drilling. This device has significant advantages over current technology, being percutaneous, portable, and using no fluoroscopy for targeting. This device can allow shorter surgery, decreased radiation exposure, and fewer complications for the surgeon and patient.

Download Full-text

Comparing Effectiveness Between a Power-Drill-Mounted Device and Conventional Free-Handed Technique for Distal Locking of Intramedullary Implants

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00229 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0022

Author(s):

Supachoke Wattanakitkrileart ◽

Boonsin Tangtrakulwanich ◽

Varah Yuenyongviwat

Keyword(s):

Radiation Exposure ◽

Exposure Time ◽

Operative Time ◽

Operating Time ◽

Surgical Team ◽

Intramedullary Nails ◽

Distal Locking ◽

Orthopedic Surgeons ◽

Power Drill ◽

Intramedullary Implants

Objectives: The procedure for distal locking of intramedullary nails (IM nail) is one of the time-consuming procedures and also exposes the surgical team and patient to high levels of radiation. Many techniques and devices have been created to solve the problems. Nonetheless, conventional free-hand technique is still the most popular due to easy-to-use and no added device needed. This research aims to study the accuracy of a drill-mounted device with free-handed technique in the distal locking of IM nail procedure. Methods: This is an experimental study. The device was made from PVC pipes. In this study, IM-nail-inserted synthetic femoral bones (Synbone®) were set as in IM nail procedure. Four orthopedic surgeons were instructed and performed the distal locking procedure with free-handed technique and then with the device (totally 20 times for each technique). The radiation exposure time and operating time were recorded. Results: The drill-mounted device reduced the radiation exposure time statistically significant lower than the free-handed technique. However, there was no different in operative time between the two techniques. Screw misdirection occurred two times in free-handed technique but not found in our device-assisted group. Conclusion: In this experiment, the new-designed device can reduce the radiation exposure time in distal IM nail interlocking procedure. Nonetheless, further clinical study is required to confirm our results.

Download Full-text

Site-Specific Radiation Exposure during Intramedullary Nails: A Comparison between the Free-Hand Technique and the Electromagnetic Assisted Technique

Biomedical Journal of Scientific & Technical Research ◽

10.26717/bjstr.2018.03.000892 ◽

2018 ◽

Vol 3 (3) ◽

Author(s):

Hiroki Kobayashi

Keyword(s):

Radiation Exposure ◽

Intramedullary Nails ◽

Site Specific ◽

Free Hand Technique

Download Full-text

Perceptions and Realities for Distal Freehand Interlocking of Intramedullary Nails

Advances in Orthopedics ◽

10.1155/2015/834582 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5

Author(s):

Robert F. Ostrum

Keyword(s):

Fracture Pattern ◽

Orthopaedic Trauma ◽

Intramedullary Nails ◽

Orthopaedic Surgeons ◽

Distal Interlocking

There is a perception that distal freehand interlocking (DFHI) of intramedullary nails can be difficult and time consuming. This study consists of a survey of surgeons’ practices for DFHI screws and their reasons for not using this technique. A survey was sent to 1400 orthopaedic surgeons who were asked to agree or disagree with statements regarding the difficulty and indications for the usage of distal freehand interlocking screws. The results were analyzed by practice demographics, resident availability, and completion of an orthopaedic trauma fellowship. Overall, 316 surgeons (22.6%) responded to the survey. Fellowship trained surgeons were 60% less likely to find DFHI difficult when compared to nonfellowship surgeons and surgeons with residents were 76% less likely to perceive DFHI as difficult than surgeons without residents. In all groups, 40–43% of surgeons used distal interlocking based on their comfort with the technique and not the fracture pattern. Distal freehand interlocking is perceived as difficult by community orthopaedic surgeons without residents and surgeons who have not done an orthopaedic trauma fellowship. Forty percent of surgeons based their usage of DFHI screws on their comfort with the technique and not the fracture pattern.

Download Full-text

Stereo Fluoroscopy-Assisted Distal Interlocking of Intramedullary Nails

Journal of Orthopaedic Trauma ◽

10.1097/00005131-199705000-00014 ◽

1997 ◽

Vol 11 (4) ◽

pp. 300-303 ◽

Cited By ~ 12

Author(s):

Takashi Ohe ◽

Kozo Nakamura ◽

Takashi Matsushita ◽

Masayuki Nishiki ◽

Naoto Watanabe ◽

...

Keyword(s):

Intramedullary Nails ◽

Distal Interlocking

Download Full-text

Biomechanical Testing of the Compressive Strength of Various Distal Locking Screw Options for Intramedullary Nails in the Treatment of Tibia Fractures

ASME 2011 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2011-53838 ◽

2011 ◽

Author(s):

Fred Xavier ◽

Elan Goldwyn ◽

Westley T. Hayes ◽

Alexandra Carrer ◽

Max Berdichevsky ◽

...

Keyword(s):

Testing Machine ◽

Biomechanical Testing ◽

Intramedullary Nails ◽

Group Iii ◽

Distal Locking ◽

Locking Screws ◽

Distal Interlocking ◽

Group I ◽

Tibia Fractures ◽

Torsional Stability

Treatment of distal third tibia fractures remains challenging. New intramedullary nails provide torsional stability by using distal interlocking screws. In this study we attempted to determine the most biomechanically stable number and configuration of distal locking screws. The distal part of human cadaveric tibia bones was nailed using a tibial nail (Stryker T2). Distal locking was performed in three different configurations: (a) Group I: 2 screws in the medio-lateral (ML) direction, (b) Group II: 1 ML screw and 1 Screw in the antero-posterior (AP) direction, and (c) Group III: 2 ML screws and 1 AP screw. The specimens were then mounted onto a mechanical testing machine (Instron) and tested in compression. The load carrying capacity of the samples from Group III with these locking screws was higher than Group I & II, although this difference was not statistically significant.

Download Full-text