A new mechanical aiming device for the placement of distal interlocking screws in femoral nails

作者: C. Krettek , B. Könemann , T. Miclau , R. Kölbli , T. Machreich

DOI: 10.1007/S004020050215

关键词: Cadaveric spasmOrthodonticsFluoroscopyCadaverFracture fixationInterlockingMedicineIntramedullary rodFemurImplantSurgery

摘要: Although the free-hand technique remains most popular method for distal interlocking screw insertion, a proximally mounted "radiation-independent" device which compensates implant deformation has been developed. In 15 intact human cadaveric femora same surgeon performed statically locked intramedullary nailing using aiming system. Operation time, total radiation time and accuracy of placement were measured radiation-independent The average operation was 21.2+/-8.6 min, locking (2 screws) 7.1+/-2.4 min. declined over first 10 cases. These times did not significantly improve in subsequent 5 procedures. fluoroscopy 28.1+/-16.6 s. None placements required use fluoroscopy. Drill-nail contact absent drillings, mild 9 moderate 16 severe none. Measurement damage showed 55 60 measurements wear less than microm. There no failures or major complications. A minor complication related to observed one specimen. This study suggests that screws can be placed successfully arm-based system, accounts nail deformations. (DAD) learned easily. main advantages arm include elimination during precise with little insertion-related hardware damage.

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