An Effective Method for Intramedullary Fixation of Long Bone Fractures Reducing the Operative Duration and Flouroscopy Time: Guide Wire Assisted Nail Locking

Abstract

Objectives: Intramedullary nailing is still the gold standard surgical technique in treatment of long bone diaphyseal fractures. In this surcigal procedure, distal locking phase gives rise to increased operative durations and flouroscopy time. Various device and techniques has been developed to overcome this issue. In our study, we aimed to investigate a practical and inexpensive technique for insertion of distal locking screws in intramedullary nailing of long bone diaphyseal fractures. Methods: 90 patients with diaphyseal fractures of tibia(48) and femur(42) who underwent intramedullary nailing were enrolled for this study. Classical Free Hand Locking (FHL) and Guidewire Assisted Locking (GAL) techniques were performed in distal locking phase of the procedure on 51 and 39 cases, respectively. These techniques were compared according to the influence on total operative duration and c-arm flouroscopy time. Results: GAL technique compared to FHL technique was provided statistically significant reduction in operative duration of both femur fractre surgery (75 vs 93 min., p