title: Evaluation of the Stryker S2 IM Nail Distal Targeting Device for reduction of radiation exposure: a case series study.
abstract: Distal locking is one challenging step during intramedullary nailing of femoral shaft fractures that can lead to an increase of radiation exposure. In the present study, the authors describe a technique for the distal locking of femoral nails, implementing a new targeting device in an attempt to reduce radiation exposure and operational time. Over a 2-year period, 127 consecutive cases of femoral shaft fractures were included in the study. All cases were treated with nailing of femoral shaft fractures with an unslotted reamed antegrade femoral nail and distal locking was performed with the use of a proximally mounted aiming device. Mean duration of the procedure was 63.5 18.1 min while the duration for distal locking was 6.6 +/- 2.6 min. In all successful cases, exposure from intraoperative fluoroscopy was 17.2 +/- 7.4 s for the whole operative procedure, and for distal locking was 2 shots, 1.35 s (range, 0.9-2.2 s) and 1.9 mGy (range, 1.1-2.9 mGy). Five cases (3.9%) were unsuccessful, but overall no intraoperative complications were encountered from the application of this technique. The ability of the device to correspond to the level of nail deformation and to properly identify the distal holes, reduced exposure to radiation compared to other published reports, and should be considered as a valuable tool for distal locking of femoral fractures.
authors.affiliation: 2nd Department of Orthopaedic & Trauma Surgery, G. Gennimatas General Hospital of Athens, 154 Mesogeion Avenue, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Anastopoulos
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Ntagiopoulos
authors.forename: Dionisios
authors.initials: D
authors.lastname: Chissas
authors.forename: George
authors.initials: G
authors.lastname: Loupasis
authors.forename: Antonios
authors.initials: A
authors.lastname: Asimakopoulos
authors.forename: Eustratios
authors.initials: E
authors.lastname: Athanaselis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Megas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005264:Femoral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D005471:Fluoroscopy; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control; D011446:Prospective Studies; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D013997:Time Factors