Interlocking intramedullary nails. An improved method of screw placement combining image intensification and laser...

Insertion of distal interlocking screws in femoral nails can be technically demanding and may entail substantial exposure. A method of insertion of femoral interlocking screws that uses a laser guiding system in addition to the standard image intensifier was used in an attempt to improve the accuracy of distal screw placement and to limit radiation exposure. Using this technique, 97% of the distal femoral drill holes attempted were successfully made with the first pass of a drill. Little or no resistance to the drill was met from contacting the femoral nail. Average fluoroscopy time was 0.4 minute. Laser-assisted screw placement requires relatively inexpensive modifications of existing equipment and is easy to master. Compared with the more commonly used freehand method, laser-assisted screw placement appears to offer a reduction in the amount of time and radiation exposure required to insert distal interlocking femoral screws.