Reducing intraoperative duration and ionising radiation exposure during the insertion of distal locking screws of intramedullary nails: a small-scale study comparing the current fluoroscopic method against radiation-free, electromagnetic navigation

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.

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Validations of Computer-Assisted Orthopaedic Surgical System for insertion of distal locking screws for intramedullary nails

International Congress Series ◽

10.1016/j.ics.2004.03.122 ◽

2004 ◽

Vol 1268 ◽

pp. 614-619 ◽

Cited By ~ 4

Author(s):

Sabur Malek ◽

Roger Phillips ◽

Amr Mohsen ◽

Warren Viant ◽

Mike Bielby ◽

...

Keyword(s):

Computer Assisted ◽

Intramedullary Nails ◽

Distal Locking ◽

Locking Screws ◽

Surgical System

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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.

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