title: Fluoroscopic freehand and electromagnetic-guided targeting system for distal locking screws of humeral intramedullary nail.
abstract: OBJECTIVE
  The current techniques used to lock distal screws for the nailing of long bone fractures expose the surgeons, radiologists and patients to a hearty dose of ionizing radiation. The Sureshot™ Distal Targeting System is a new technique that, with the same results, allows for shorter surgery times and, consequently, less exposure to radiation.
  
  
  METHODS
  The study was performed on 59 patients (34 males and 25 females) with a simple humerus fracture diagnosis, type 1.2.A according to the AO classification, who were divided into two groups. Group 1 was treated with ante-grade intramedullary nailing with distal locking screws inserted with a freehand technique. Group 2 was treated with the intramedullary nail using the Sureshot™ Distal Targeting System. Two intra-operative time parameters were evaluated in both groups: the time needed for the positioning of the distal locking screws and the time of exposure to ionizing radiations during this procedure.
  
  
  RESULTS
  Group 2 showed a lower average distal locking time compared to group 1 (645.48″ vs. 1023.57″) and also a lower average time of exposure to ionizing radiation than in group 1 (4.35″ vs. 28.96″).
  
  
  CONCLUSIONS
  The Sureshot™ Distal Targeting System has proven to be equally effective when compared to the traditional techniques, with the added benefits of a significant reduction in both surgical time and risk factors related to the exposure to ionizing radiation for all the operating room staff and the patient.
authors.affiliation: Department of Anatomical Sciences, Histological, Forensic Medicine and Locomotive System, Sapienza University of Rome, Piazzale Aldo Moro n ° 5, Rome, Italy. ppersiani@me.com.|Department of Orthopaedics and Traumatology, Sapienza University of Rome, Piazzale Aldo Moro n ° 5, Rome, Italy. ppersiani@me.com.
authors.forename: P
authors.identifier: http://orcid.org/0000-0001-5795-3337
authors.initials: P
authors.lastname: Persiani
authors.affiliation: Department of Anatomical Sciences, Histological, Forensic Medicine and Locomotive System, Sapienza University of Rome, Piazzale Aldo Moro n ° 5, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gurzi
authors.affiliation: Department of Anatomical Sciences, Histological, Forensic Medicine and Locomotive System, Sapienza University of Rome, Piazzale Aldo Moro n ° 5, Rome, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Moreschini
authors.affiliation: Department of Anatomical Sciences, Histological, Forensic Medicine and Locomotive System, Sapienza University of Rome, Piazzale Aldo Moro n ° 5, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Giacomo
authors.affiliation: Department of Anatomical Sciences, Histological, Forensic Medicine and Locomotive System, Sapienza University of Rome, Piazzale Aldo Moro n ° 5, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Villani
mesh_terms: D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D016022:Case-Control Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Electromagnetic guided; Humeral trauma; Interlocking screw; Intramedullary nail; Radiation exposure; Radiation free