title: [A comparison of a fluoroscopy-free mechanical targeting system and a free-hand technic for the placement of distal interlocking screws of tibial nails].
abstract: Recently, radiation-independent aiming devices for the tibia which compensate for insertion-related implant deformation have been developed, but the benefits of such systems have not been determined. This study prospectively evaluated the duration of the nailing procedure, the length of radiation time, and the accuracy of interlocking screw placement with a radiation-independent distal aiming system and the free-hand technique. In an oblique cadaveric tibial fracture, a surgeon inexperienced with either technique performed a statically locked intramedullary nailing. For the aiming system and free-hand technique respectively, the total operation time was 25.4 +/- 11.3 vs 30.9 +/- 14.3 min (P = 0.029), the distal locking time was 16.7 +/- 8.6 vs 21.9 +/- 10.5 min (P = 0.004), the total fluoroscopy time was 9 +/- 5 vs 93 +/- 34 s (P < 0.0001), the distal locking fluoroscopy time was 0 versus 88 +/- 33 s (P < 0.0001), and the screw destruction was -0.7 +/- 5.2 vs 26.8 +/- 31.6 microns (P = 0.001). The failure rate was 1.6% (1 of 60 screws) in both groups. These results suggest that aiming devices can eliminate the need for radiation during distal interlocking screw placement.
authors.affiliation: Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
authors.forename: C
authors.initials: C
authors.lastname: Krettek
authors.forename: B
authors.initials: B
authors.lastname: Könemann
authors.forename: O
authors.initials: O
authors.lastname: Farouk
authors.forename: A
authors.initials: A
authors.lastname: Kromm
authors.forename: P
authors.initials: P
authors.lastname: Schandelamier
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000706:statistics & numerical data; D001863:Bone Screws / Q000706:statistics & numerical data; D002102:Cadaver; D005069:Evaluation Studies as Topic; D005471:Fluoroscopy / Q000295:instrumentation / Q000706:statistics & numerical data; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors
vernacular_title: Vergleich eines durchleuchtungsfreien mechanischen Zielsystems und einer Freihandtechnik für die Plazierung von distalen Verriegelungsschrauben von Tibianägeln.