Distal Locking Using an Electromagnetic Field–Guided Computer-Based Real-Time System for Orthopaedic Trauma Patients

Langfitt, Maxwell K.; Halvorson, Jason J.; Scott, Aaron T.; Smith, Beth Paterson; Russell, Gregory B.; Jinnah, Riyaz H.; Miller, Anna N.; Carroll, Eben A.

doi:10.1097/bot.0b013e31828c2ad1

Cited by 25 publications

(19 citation statements)

References 19 publications

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“…However, extended periods of operation should be considered for misplacement of the distal locking screws. [18] …”

Section: Discussionmentioning

confidence: 99%

“…Compared with the free-hand technique, the electromagnetic technique has a short learning curve for the inexperienced surgeon. Langfitt et al [18] found that junior residents spent more time on inserting the distal screw with the free-hand technique. It is inevitable for the surgeon to receive an excessive dose of radiation, especially for surgeons who do not often perform intramedullary nailing.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails

Han

Shi

et al. 2017

Medicine

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Background:Although the method has been used widely, one of the greatest challenges for intramedullary nailing is to position the distal locking screw. A new technology, the electromagnetic navigation system, is a radiation-free way to locate the position of the drill bit and provide 3-dimensional real-time feedback of location and orientation of the drill bit relative to the locking holes. The purpose of our study was to evaluate the reliability and efficiency of the free-hand technique compared to the new electromagnetic navigation system.Methods:Fifty-four patients with femoral fracture who needed treatment with intramedullary nails were divided into 2 groups. One group including 26 patients underwent distal locking using the standard free-hand method, whereas the electromagnetic navigation system was used with the other 29 patients. Intraoperative fluoroscopy exposure times, screw insertion times, and healing times were recorded; these parameters were used for comparison between the 2 groups.Results:There were 17 males and 9 females who had femoral intramedullary nails using the free-hand technique, whereas 21 males and 8 females received intramedullary nails using the electromagnetic navigation system. The mean time of distal locking was 19.5 ± 6.0 minutes in the free-hand (FH) group, whereas the time was 6.1 ± 1.4 minutes in the electromagnetic (ET) group. The exposure time for the FH group was 26.8 ± 13.3 seconds and 2.2 ± 1.1 seconds for the ET group. Healing time proved to be comparable in the FH and ET groups (16.4 ± 3.7 weeks vs 15.1 ± 2.8 weeks).Conclusion:Under the premise of achieving the same effect, the electromagnetic navigation system has the advantage of less distal locking time and less radiation dose.

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“…However, extended periods of operation should be considered for misplacement of the distal locking screws. [18] …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails

Han

Shi

et al. 2017

Medicine

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“…However, EM-guided locking SI resulted in a significantly shorter time needed for the procedure and completely eliminated radiation exposure. Langfitt et al [27] compared the efficacy of the two techniques in terms of time and number of interlocking screw misses on 24 tibial nails and 24 femoral nails, which were blocked with 2 distal screws (one by free hand technique and one by electromagnetic fieldguided computer-based real-time system -EFRTS). The results suggest that EFRTS is faster than the traditional freehand technique and results in fewer screw misses.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of TRIGEN SURESHOT® distal targeting system - A new electromagnetic computer-assisted guidance system

Veliceasa

Bandac²,

Popescu

et al. 2015

2015 E-Health and Bioengineering Conference (EHB)

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Intramedullary nailing (IMN) remains the standard technique for the treatment of diaphyseal fractures of long bones. Recently, a new system has been introduced, TRIGEN SURESHOT®, designed by SMITH & NEPHEW, in which distal lockage of IMN no longer requires fluoroscopy. 102 patients (mean age 35.8) with closed diaphyseal fractures (34 femoral shaft and 68 tibial shaft fractures) were treated by IMN using the SURESHOT® for distal interlocking. The accuracy was 97.05%; intraoperative technical difficulties were encountured in 9 cases -5 tibial and 4 femoral nails (1 antegrade and 3 retrograde). The average time of insertion of both distal interlocking screws was: 235.6 sec (between 228 and 246 sec) for antegrade femoral nails, 247.5 sec (between 236 and 268 sec) for retrograde femoral nails and 219.2 sec (between 202 and 251 sec) for tibial nails. This new method avoids exposure to ionizing radiation, while showing an accuracy of 96-100% and a low learning curve.

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“…3 For these reasons, alternate techniques to insert distal locking screws have been proposed, including nail-mounted guides, c omputer navigation, and self-locking nail systems. [4][5][6][7][8][9][10] This evidence pertains to practicing orthopaedic surgeons and residents who have already performed the procedure with fluoroscopic guidance. Compared with conventional fluoroscopic freehand technique, emerging evidence suggests that the use of this device can minimize the number of misses in screw insertion and decrease operative time and radiation dose.…”

Section: Introductionmentioning

confidence: 99%

“…2 Recently, an electromagnetic (EM) targeting device that assists in the insertion of distal locking screws has been introduced (SURESHOT Distal Targeting System; Smith and Nephew, Memphis, TN). [4][5][6][7][8][9][10] There are currently no data examining the use of this technology to teach novice surgical trainees how to perform the procedure-the population of individuals that may have the most difficulty with the freehand technique. [4][5][6][7][8][9][10] This evidence pertains to practicing orthopaedic surgeons and residents who have already performed the procedure with fluoroscopic guidance.…”

Section: Introductionmentioning

confidence: 99%

Training Distal Locking Screw Insertion Skills to Novice Trainees

Leroux

Khoshbin

Nousiainen³

2015

Journal of Orthopaedic Trauma

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Distal Locking Using an Electromagnetic Field–Guided Computer-Based Real-Time System for Orthopaedic Trauma Patients

Abstract: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 25 publications

References 19 publications

Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails

Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails

Evaluation of TRIGEN SURESHOT® distal targeting system - A new electromagnetic computer-assisted guidance system

Training Distal Locking Screw Insertion Skills to Novice Trainees

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