Experimental model for a new distal locking aiming device for solid intramedullary tibia nails

Abdlslam, Kalid M.; Bonnaire, F.

doi:10.1016/s0020-1383(02)00194-8

Cited by 26 publications

(12 citation statements)

References 3 publications

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“…However, its main drawbacks are cost and the need for a reliable intraoperative image intensifier support [5,6,22,25]. There are now nails that can be locked with the aid of external jigs [1,3,12,16,22,24,25]. In this study, 100% of the fractures were fixed without the use of an image intensifier with the satisfactory placement of nails and screws in all cases.…”

Section: Discussionmentioning

confidence: 85%

Achieving interlocking nails without using an image intensifier

Ikem

Ogunlusi

Ine

2006

International Orthopaedics (SICO

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Interlocking nails are commonly performed using an image intensifier. These are expensive and are not readily available in most resource-poor countries of the world. The aim of this study was to achieve interlocking nailing without the use of an image intensifier. This is a prospective descriptive analysis of 40 consecutive cases seen with shaft fractures of the humerus, femur, and tibia. Fracture fixation was done using Surgical Implant Generation Network (SIGN) nails. Forty limbs in 34 patients were studied. There were 12 females and 22 males, giving a ratio of 1:2. The mean age (years) was 35.75± 13.16 and the range was 17-70 years. The studied bones were: humerus 10%, femur 65%, and tibia 25%. The fracture lines were: transverse 40%, oblique 15%, and communited 45%. Fracture grades were: closed 90%, grade I, 5%, grade II, 2.5%, and grade IIIA, 2.5%. Surgical approaches were: antegrade 62.5% and retrograde 37.5%. Indications for fixation were: recent fracture 92.5%, non-union 5%, and malunion 3%. Methods of reductions were: open 85% and closed 15%. The mean follow-up period (years) was 1.50±0.78. The union time averaged 3 months. Complication was mainly screw loosening due to severe osteoporoses in one case. It is, therefore, concluded that, with the aid of external jigs and slot finders, interlocking can be achieved without an image intensifier.Résumé Les clous verrouillés sont d'utilisation commode mais demande une imagerie dans leur utilisation. Cette imagerie est chère et ne peut être réalisée de façon valable dans les pays pauvres. Le but de cette étude est de montrer que le verrouillage des clous peut se faire sans l'utilisation d'une imagerie. Il s'agit d'une étude prospective de 40 cas de fracture de la diaphyse humérale, fémorale ou tibiale, la fixation de ces fractures étant réalisée par un clou de type SIGN. 40 membres chez 34 patients ont été étudiés, 12 femmes, 22 hommes (ratio de 12). L'âge moyen a été de 35,75±13,16 s'échelonnant de 17 à 70 ans. Les fractures affectaient l'humérus dans 10% des cas, le fémur dans 65% des cas et le tibia dans 25% des cas. La fracture était transverse dans 40% des cas, oblique dans 15% et communitive dans 45% des cas. Il s'agissait d'une fracture fermée dans 9 cas sur 10. Lorsqu'elle était ouverte, de grade I dans 5%, de grade II dans 2,5% et de grade IIIA dans 2,5%. L'approche chirurgicale a été antérieure dans 62,5% des cas et postérieure dans 37,5% des cas. Il s'agissait d'enclouage pour fixer une fracture fraîche dans 92,5% des cas, après pseudarthrose dans 5% des cas et cal vicieux dans 3% des cas. La réduction a été réalisée par voie sanglante dans 85% des cas, à foyer fermé dans 5% des cas. Le suivi moyen a été de 1,50±0,78, la consolidation a été obtenue en moyenne en 3 mois. Une seule complication avec mobilisation d'une vis après une ostéoporose sévère a été observée dans un seul cas. Nous pouvons conclure qu'il est possible, grâce à la méthode que nous décrivons de verrouiller un clou sans imagerie.

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Section: Discussionmentioning

confidence: 85%

Achieving interlocking nails without using an image intensifier

Ikem

Ogunlusi

Ine

2006

International Orthopaedics (SICO

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“…[11,12] In order to overcome the problems regarding DI, various techniques and devices have been developed. [13][14][15][16][17][18][19] Despite their developments, no system has gained common acceptance and popularity; thus, DI remains a problem.…”

Section: Resultsmentioning

confidence: 99%

A newly designed intramedullary nail with distal interlocking system for tibia fractures in adults - the clinical results

Küçükdurmaz¹,

Akpınar²,

Saka³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇTibia kırıklarının cerrahi tedavisinde oymalı ve oymasız seçenekler vardır. Oymalı çivilerin biyomekanik üstün-lükleri vardır ancak endosteal dolaşıma önemli ölçüde zarar verir. Oymasız çiviler ise endosteal dolaşımı korur fakat daha az stabil bir sabitleme sağlar. Her iki sistemde de distal kilit vidası kaynaklı instabilite nedeniyle hemen tam ağırlık vermek mümkün değildir. Ayrıca, distal kilit vidası, skopi kullanma ihtiyacının ve cerrahi sürenin uzamasından sorumludur. Bu çalışmada, yeni intramedül-ler çivi ve oymasız sistemle stabil bir sabitleme sağlayıp hemen tam ağırlık vermeye izin veren distal kilit vidası sisteminin klinik sonuçları sunuldu. GEREÇ VE YÖNTEM2008 ile 2010 yılları arasında yeni intramedüller sistemle ameliyat edilmiş 50 tibia kırığı (49 hasta) geriye dönük olarak değerlendirildi. Ameliyattan hemen sonraki 1. gün tam ağırlığa izin verildi. Hastalar ameliyat sonrası en az 10 ay takip edildi. BULGULARDistal kilitleme için ortalama skopi süresi 18 saniye (min: 10, maks: 30) idi. Ortalama kaynama süresi 9 hafta (min: 6, maks: 12). Nörovasküler yaralanma, derin enfeksiyon, yanlış veya gecikmiş kaynama ve kaynamama yoktu. SONUÇBiz bu çalışmamızla yeni geliştirdiğimiz intramedüller çi-vinin ve distal kilit vidası sisteminin distal kilit vidasından kaynaklanan stabilite problemlerinin çözülmesinde bir seçenek olabileceğini gösterdik. Ayrıca sistemimiz ameliyatta gereken skopi ihtiyacını da önemli ölçüde azaltmaktadır.Anahtar Sözcükler: Distal kilit vidası; skopi; hemen tam ağırlık verme; stabilite; tibia kırığı.

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“…Although the problem of proximal locking is already solved, distal locking needs further improvement (4). At present, the free-hand technique (5, 6) is the most popular method (7).…”

Section: Introductionmentioning

confidence: 99%

“…At present, the free-hand technique (5, 6) is the most popular method (7). Generally, a skilled surgeon and an experienced radio-technician are required for achieving accurate distal locking in the least possible time with the least possible exposure to radiation (4, 8-10). Even though a lead apron provides adequate protection to surgeon’s trunk and gonads (11), her/his hands are frequently directly exposed to the x-ray beam.…”

Section: Introductionmentioning

confidence: 99%

Is a Magnetic-Manual Targeting Device an Appealing Alternative for Distal Locking of Tibial Intramedullary Nails?

Negrin

Vécsei

2013

Arch Trauma Res

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BackgroundIn order to enable a radiation-free, accurate and simple positioning of distal locking screws, a combined magnetic and manual targeting system has been developed by Sanatmetal®. Where a low-frequency magnetic field is initially used to detect the position of the first drill hole and three more holes can be found with a mechanical template.ObjectivesOur cadaver study was performed to evaluate the accuracy and efficiency of this device.Materials and MethodsIn two runs, 30 probands (group 1: 10 students; group 2: 10 residents; group 3: 10 attendings), none of who being familiar with the device, tested the radiation-free system using 60 intact cadaver tibias. Each proband performed the surgical procedure twice in succession.ResultsReferring to the first attempts, 9.6, 7.2 and 7.1 minutes were the time periods required to insert the four distal screws and the relevant values for the second attempts were 8.6, 6.3 and 6.2 minutes; in both cases revealing a significant difference between group 1 and 2 and group 1 and 3. Furthermore, the mean values within each group indicated a significant decrease of the test duration. Out of the 240 drillings, only one failure (group 1) occurred, representing an accuracy of 99.58 %. Of the probands, 90 % rated the targeting device better than the free-hand technique and 77 % at least attested a high user-friendliness.ConclusionsDue to our satisfactory test results, the brief training, the steep learning curve and the radiation-free technique the new device has to be considered an appealing alternative for distal locking.

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Experimental model for a new distal locking aiming device for solid intramedullary tibia nails

Cited by 26 publications

References 3 publications

Achieving interlocking nails without using an image intensifier

Achieving interlocking nails without using an image intensifier

A newly designed intramedullary nail with distal interlocking system for tibia fractures in adults - the clinical results

Is a Magnetic-Manual Targeting Device an Appealing Alternative for Distal Locking of Tibial Intramedullary Nails?

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