A comparison of free-hand method and electromagnetic navigation technique for the distal locking during intramedullary nailing procedures: a meta-analysis

Zhao, Xiaoxu; Fan, Yonggang; Chen, Juwu

doi:10.1007/s00402-020-03456-w

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…It takes more operative and radiation exposure time for novice surgeons. Repeated positioning can lead to lateral cortical defect, reduce the stability of interlocking nail and cortex, which will result in nail withdrawal and affect the surgical effect of internal fixation 26 . Compared with the freehand method, the laser guiding navigation device could shorten the operative time, increase the first success rate and improve the efficiency of the operation.…”

Section: Discussionmentioning

confidence: 99%

A New Accurate, Simple and Less Radiation Exposure Device for Distal Locking of Femoral Intramedullary Nails

Gao¹,

Liu²,

Wang³

et al. 2021

IJGM

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Background Due to the metal elasticity of intramedullary nails (IMs) and irregularities of the long bone marrow cavity and other reasons, one of the greatest challenges for surgeons is to position the distal locking screw. Therefore, a novel laser guiding navigation device was designed for the distal locking of femoral IMs. The purpose of this study was to compare the effectiveness of the novel device and freehand technique for distal locking of IMs in the femoral model. Methods The laser guiding navigation device (laser group) and freehand technique (freehand group) were used in the distal locking of the IMs in the femoral model. All operations were performed by surgeons of the same level. The differences between the two groups were compared in terms of operative time, radiation exposure time, first success rate, deviation angle between ideal trajectory and actual trajectory, and learning curve. Results The distal locking of the IMs in the femoral model was performed 40 times in each group. The results showed that the laser group was better than the freehand group in terms of operative time (345±165 VS 212±105 seconds, t=4.27, P<0.001 ), radiation exposure time (164±57 VS 41±15 seconds, t=13.15, P<0.001 ) and first successrate ( χ 2 =21.36, P <0.001). Compared with the freehand group, the actual trajectory of the laser group was closer to the ideal trajectory in coronal and horizontal planes. Furthermore, the learning curve time of the laser group was shorter. Conclusion Compared with traditional freehand technique, the novel laser guiding navigation device can shorten the operative time and reduce radiation exposure invitro. In addition, it is easy to master with more accuracy and a higher first success rate in vitro.

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Section: Discussionmentioning

confidence: 99%

A New Accurate, Simple and Less Radiation Exposure Device for Distal Locking of Femoral Intramedullary Nails

Gao¹,

Liu²,

Wang³

et al. 2021

IJGM

View full text Add to dashboard Cite

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“…[7,8] The decision to employ one technique over the other often depends on various factors, including patient-specific characteristics and the surgeon's experience and expertise. [9] Although prior studies have established the individual benefits and drawbacks of each technique, a comprehensive comparative study exploring their effects on specific health outcomes remains limited. [10] The surgical team's expertise and patient characteristics often dictate the chosen approach.…”

Section: Introductionmentioning

confidence: 99%

Fluoroscopy-free distal screw locking in intramedullary nailing: A retrospective study

Menekse

2023

Medicine

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Intramedullary nailing is a common orthopedic procedure, but current methods for distal screw locking have several limitations. This study introduces and evaluates a novel technique that aims to overcome these challenges. The findings were statistically significant, with P-values set at .05. Compared to the traditional method, the novel technique demonstrated several advantages. Mean operation times were reduced to 1.2 hours for the new method, in contrast to 1.5 hours for the control group. Hospital stays also favored the new technique, with a mean duration of 2 days, while the control group averaged 3 days. A significant benefit was the marked decrease in radiation exposure, with the new technique eliminating radiation entirely, recording 0.0 mSv compared to the control group’s 2.5 mSv. The procedure’s success, gauged by the accurate positioning of screws, was higher for the new technique at 92% versus the control’s 78%. Furthermore, complication rates were notably lower in the new method, with a 6% incidence compared to 16% in the traditional approach. While the data suggest that the new technique holds promising advantages, such as reduced operation times, decreased radiation exposure, and fewer complications, it is essential to conduct more extensive research for comprehensive validation. Despite the optimistic results, the study acknowledges the need for larger-scale trials to solidify these findings.

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“…Intramedullary nailing is one of the current standard treatments for long bone diaphyseal fractures [1][2][3], however, positioning the distal locking screw is one of the greatest challenges [4][5][6][7], especially for novice surgeons. Many novel technologies have been invented to optimize the locking procedure, such as electromagnetic navigation technology, computer-aided navigation technology, orthopedic robots and so on [8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Comparison of freehand technique and a novel laser guiding navigation in distal locking of femoral intramedullary nails: a randomized controlled trial

et al. 2022

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Background Intramedullary nail (IMN) is one of the key essential minimally invasive “weapons” in orthopaedic trauma, while the distal locking is still challenging for surgeons. Although there are various inventions and technologies to improve the locking procedure, there are still problems such as inaccurate positioning, excessive radiation exposure, low first success rate and long learning curve. Therefore, a new laser guiding navigation device was designed and compared with the traditional freehand (FH) technique in the distal locking of femoral IMN. Methods This randomized controlled single-blind trial recruited patients with femoral diaphyseal fracture. The self-designed laser navigation device (laser group) and freehand technique (FH group) were used in the distal locking of the IMNs. The patients enrolled were randomized into FH group and laser group, all operations were performed by two surgeons of the same level. The differences between the two groups were compared in terms of radiation exposure time, operative time, first success rate, blood loss, visual analogue score (VAS), Harris score and healing time. Results 32 patients ended the study period and 16 patients in each group. The results showed that the laser group was better than the FH group in terms of distal locking time (10(9/11) vs 19.5 (17.25/21) min, Z = 4.83, P < 0.001), distal locking radiation exposure time (46.5 (41.25/51.75) vs 105 (88.25/140) s, Z = 4.807, P < 0.001), first success rate (30/32 vs 20/32, χ2 = 9.143, P = 0.002) and blood loss (60 (50–100) vs 150 (105–192.5) mL, Z = 3.610, P = 0.0003). There was no difference in Harris score, VAS score, or fracture healing time between the two groups. Conclusion Compared with the FH technique, the novel laser guiding navigation device for distal locking of femoral IMN has the advantages of shorter operative time, less radiation exposure and higher first success rate. Trial registration Chinese Clinical Trial Registry, ChiCTR2200060236. Registered 23 May 2022, https://www.chictr.org.cn/showprojen.aspx?proj=169130

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A comparison of free-hand method and electromagnetic navigation technique for the distal locking during intramedullary nailing procedures: a meta-analysis

Cited by 5 publications

References 22 publications

A New Accurate, Simple and Less Radiation Exposure Device for Distal Locking of Femoral Intramedullary Nails

A New Accurate, Simple and Less Radiation Exposure Device for Distal Locking of Femoral Intramedullary Nails

Fluoroscopy-free distal screw locking in intramedullary nailing: A retrospective study

Comparison of freehand technique and a novel laser guiding navigation in distal locking of femoral intramedullary nails: a randomized controlled trial

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