Endoscopy-assisted distal locking of an intramedullary nail:A new experimental technique to reduce radiation exposureduring distal locking of the intramedullary nails

Abstract

Objectives: In this study, we aimed to introduce a new techniquein which distal locking step was easier and safer for orthopedictrauma surgeons involving in the treatment of long bone fracturesusing an intranail endoscopic visualization and illuminationmethod. Materials and methods: A total of 20 fresh bovine hind limbsderived from healthy adults and killed for sale were dissectedto obtain tibial bones. Two equal groups including 10 samplesin each were prepared. We applied a standard nailing processin both groups: the study group (n=10) was locked by thenew technique, intranail endoscopic illumination guidance andintranail visualization assistance locking technique and thecontrol group (n=10) was locked by the classical free-handfluoroscopic guidance technique. We measured the surgicalperiod time and the radiation exposure time required for thedistal locking in both groups. Results: The radiation exposure time was statisticallysignificantly lower in the study group compared to the controlgroup. Also, the time period required for distal locking in thestudy group were statistically significantly lower than the controlgroup. With the use of the intranail endoscopic illuminationguidance and visualization assistance technique, the medianperiod time required for the distal locking procedure reducedfrom 477.5 to 223.5 sec (p