title: Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?
abstract: OBJECTIVE
  The aim of this study was to determine whether distal locking using an electromagnetic-manual guided distal locking decreases the malrotation rate in femur fractures treated with intramedullary nailing.
  
  
  METHODS
  A total of 113 adult patients having unilateral femoral shaft fractures treated using IM nails were evaluated regarding demographic features, injury mechanism, fracture type, interval between trauma and nailing, operation time and number of image intensifier shots during the operation at least one year after nailing. Patients were divided into two groups according to distal locking technique. All patients had also undergone clinical examination for lower extremity alignment and range of motion and filled out the SF-36 questionnaire and undergone ultrasound measurement of femoral anteversion angles to reveal any rotational femoral malalignment.
  
  
  RESULTS
  Group 1 consisted of 47 patients (41.6 %) with electromagnetic-manual targeting guided distal locking and group 2 consisted of 66 patients (58.4 %) with free-hand distal locking. Both groups were statistically similar regarding demographic features, injury mechanism, fracture type, interval between trauma and nailing, clinical examination and SF-36 results. Operation time and number of image intensifier shots were significantly less in group 1. No statistically significant difference was found between the femoral anteversion angles of injured and uninjured sides of the patients in both groups.
  
  
  CONCLUSIONS
  Although there is no significant effect on malrotation, previously known advantages lead us to state that electromagnetic-manual guided distal interlocking is an advantageous treatment option in femoral shaft fractures.
authors.affiliation: Department of Orthopaedics and Traumatology, Trakya University Faculty of Medicine, Balkan Yerleskesi, 22030, Edirne, Turkey, dr.mert@gmail.com.
authors.forename: Mert
authors.initials: M
authors.lastname: Ciftdemir
authors.forename: Sedat A
authors.initials: SA
authors.lastname: Tuncel
authors.forename: Mert
authors.initials: M
authors.lastname: Ozcan
authors.forename: Cem
authors.initials: C
authors.lastname: Copuroglu
authors.forename: Murat
authors.initials: M
authors.lastname: Erem
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D055590:Electromagnetic Phenomena; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016059:Range of Motion, Articular; D055815:Young Adult