Intramedullary nail holes laser indicator, a non-invasive technique for interlocking of intramedullary nails

Abstract

Interlocking of intramedullary nails is a challenging procedure in orthopedic trauma surgery. Numerous methods have been described to facilitate this process. But they are exposed patient and surgical team to X-rays or involves trial and error. An accurate and non-invasive method has been provided to easily interlocking intramedullary nails. By transferring a safe visible light inside the nail, a drilling position appears which use to drilling bone toward the nail hole. The wavelength of this light was obtained from ex-vivo spectroscopy on biological tissues which has optimal transmission, reflectance, and absorption properties. Moreover, animal and human experiments were performed to evaluate performance of the proposed system. Ex-vivo performance experiments were performed successfully on two groups of cow and sheep samples. Output parameters were procedure time and drilling quality which there were significant differences between the two groups in procedure time (P < 0.05). But no significant differences were observed in drilling quality (P > 0.05). Moreover, an In-vivo performance experiment was performed successfully on a middle-aged man. To compare the provided method, targeting-arm, and free-hand techniques, two human experiments were performed on a middle-aged and a young man. The results indicate the advantage of the proposed technique in the procedure time (P < 0.05), while the drilling quality is equal to the free-hand technique (P = 0.05). Intramedullary nail holes laser indicator is a safe and accurate method that reduced surgical time and simplifies the process. This new technology makes it easier to interlocking the intramedullary nail which can have good clinical applications.

A Comparative Study of Freehand Technique and A Novel Laser Guiding Navigation in Distal Locking of Femoral Intramedullary Nails

“…Many novel technologies have been invented to optimize the locking procedure, however, they have the following drawbacks: complex and expensive equipment, inaccuracy and cumbersome operation(Table 3) [8,11,15,[20][21][22][23] . The freehand technique is still the ultimate option where these methods don't work and can be regarded as the gold standard.…”

“…The novel laser guiding navigation device is accurate and effective, can reduce the operation time and radiation exposure, and has a high rst success rate, which has the value of clinical promotion. (2021) [15] Tibia shaft fracture (2021) [20] Femoral model…”

“…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] . However, these technologies still cannot meet the needs of accuracy, simplicity and low radiation exposure [19] .…”

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

“…Many novel technologies have been invented to optimize the locking procedure, however, they have the following drawbacks: complex and expensive equipment, inaccuracy and cumbersome operation (Table 3) [8,11,15,[20][21][22][23]. The freehand technique is still the ultimate option where these methods don't work and can be regarded as the gold standard.…”

“…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]. However, these technologies still cannot meet the needs of accuracy, simplicity and low radiation exposure [19].…”