Comparing Results between New Aiming Device and Freehand Technique for Distal Locking of Intramedullary Implants

Supachoke Wattanakitkrileart MD*, Boonsin Tangtrakulwanich MD, PhD*, Varah Yuenyongviwat MD*

Affiliation : * Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

Objective : To test the results of a new simple aiming device compared to the freehand method for distal locking screw insertion in the intramedullary (IM) nailing procedure in terms of accuracy, radiation exposure, and operative time. Material and Method: Distal screw locking procedure on 40 synthetic femoral bones with inserted intramedullary nail was done by four senior orthopedic residents using both the freehand and device-assisted techniques. Accuracy, fluoroscopic time, and operative time were recorded for the analysis.
Results : The new aiming device minimized fluoroscopic time with statistical significance (p-value <0.001). No operating time difference between the two techniques (p-value = 0.67). Screw misdirection was found in two incidences in the freehand technique but not found in the device-assisted technique.
Conclusion : The new simple aiming device can decrease fluoroscopic time and show good precision of distal locking procedure.

Keywords : Distal locking screw, Intramedullary nail, Technique

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