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

2019 ◽  
Vol 15 (4) ◽  
Author(s):  
Simon Weidert ◽  
Lejing Wang ◽  
Juergen Landes ◽  
Philipp Sandner ◽  
Eduardo M. Suero ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Intramedullary Nails ◽  
Surgical Time ◽  
Distal Interlocking

scholarly journals Development of a Magnetic Targeting Device Applied to Interlocking of Distal Intramedullary Nail Screw Holes

2003 ◽  
Author(s):  
David C. Szakelyhidi
Keyword(s):  
Radiation Exposure ◽  
Intramedullary Nail ◽  
Magnetic Targeting ◽  
The Novel ◽  
Intramedullary Nails ◽  
Current Technology ◽  
Novel Device ◽  
Distal Interlocking ◽  
Correct Location

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.

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

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.

scholarly journals Perceptions and Realities for Distal Freehand Interlocking of Intramedullary Nails

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.

Stereo Fluoroscopy-Assisted Distal Interlocking of Intramedullary Nails

1997 ◽  
Vol 11 (4) ◽  
pp. 300-303 ◽  
Author(s):  
Takashi Ohe ◽  
Kozo Nakamura ◽  
Takashi Matsushita ◽  
Masayuki Nishiki ◽  
Naoto Watanabe ◽  
...  
Keyword(s):  
Intramedullary Nails ◽  
Distal Interlocking

scholarly journals Patient-specific template-guided versus standard freehand lumbar pedicle screw implantation: a randomized controlled trial

2021 ◽  
pp. 1-7
Author(s):  
José Miguel Spirig ◽  
Shayan Golshani ◽  
Nadja A. Farshad-Amacker ◽  
Mazda Farshad
Keyword(s):  
Randomized Controlled Trial ◽  
Radiation Exposure ◽  
Pedicle Screw ◽  
Controlled Trial ◽  
Patient Specific ◽  
Pedicle Screw Placement ◽  
Surgical Time ◽  
Screw Insertion ◽  
Pedicle Screw Insertion ◽  
Randomized Controlled

OBJECTIVE Patient-specific template-guided (TG) pedicle screw placement currently achieves the highest reported accuracy in cadaveric and early clinical studies, with reports of reduced use of radiation and less surgical time. However, a clinical randomized controlled trial (RCT) eliminating potential biases is lacking. This study compares TG and standard freehand (FH) pedicle screw insertion techniques in an RCT. METHODS Twenty-four patients (mean age 64 years, 9 men and 15 women) scheduled consecutively and independently from this study for 1-, 2-, or 3-level lumbar fusion were randomized to either the FH (n = 12) or TG (n = 12) group. Accuracy of pedicle screw placement, intraoperative parameters, and short-term complications were compared. RESULTS A total of 112 screws (58 FH and 54 TG screws) were implanted in the lumbar spine. Radiation exposure was significantly less in the TG group (78.0 ± 46.3 cGycm2) compared with the FH group (234.1 ± 138.1 cGycm2, p = 0.001). There were 4 pedicle screw perforations (6.9%) in the FH group and 2 (3.7%) in the TG group (p > 0.99), with no clinical consequences. Clinically relevant complications were 1 postoperative pedicle fracture in the FH group (p > 0.99), 1 infection in the FH group, and 2 infections in the TG group (p > 0.99). There were no significant differences in surgical exposure time, screw insertion time, overall surgical time, or blood loss between the FH and TG groups. CONCLUSIONS In this RCT, patient-specific TG pedicle screw insertion in the lumbar region achieved a high accuracy, but not better than a standardized FH technique. Even if intraoperative radiation exposure is less with the TG technique, the need for a preoperative CT scan counterbalances this advantage. However, more difficult trajectories might reveal potential benefits of the TG technique and need further research.

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

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.

Electromagnetic Navigation Reduces Surgical Time and Radiation Exposure for Proximal Interlocking in Retrograde Femoral Nailing

2014 ◽  
Vol 28 (7) ◽  
pp. 417-421 ◽  
Author(s):  
Jeremy S. Somerson ◽  
David Rowley ◽  
Chad Kennedy ◽  
Frank Buttacavoli ◽  
Animesh Agarwal
Keyword(s):  
Radiation Exposure ◽  
Surgical Time ◽  
Electromagnetic Navigation ◽  
Femoral Nailing ◽  
Retrograde Femoral Nailing
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