Distal intramedullary nail interlocking: the flag and grid technique.

Area of Science:

• Orthopedic Surgery
• Surgical Technology
• Medical Imaging

Background:

• Distal interlocking is time-consuming and involves significant radiation exposure during intramedullary nailing of long bone fractures.
• Current freehand techniques for distal interlocking can be challenging, impacting operative efficiency and patient safety.

Purpose of the Study:

• To introduce and evaluate a modified freehand technique using a metallic grid for improved distal interlocking during intramedullary nailing.
• To assess the efficacy of this technique in reducing fluoroscopy time, operative time, and radiation exposure.

Main Methods:

• A metallic grid was used as a navigational aid attached to the skin (femur or tibia).
• Fluoroscopic visualization determined the position of distal nail holes relative to the grid.
• A modified Steinmann pin with a "flag" handle facilitated targeting and screw hole creation.

Main Results:

• The modified technique demonstrated a reduction in radiation exposure compared to the traditional freehand method.
• Total distal interlocking time was significantly decreased using the metallic grid technique.
• No significant complications were associated with the modified technique.

Conclusions:

• The metallic grid-assisted technique offers an effective and safer alternative for distal interlocking in intramedullary nailing.
• This method improves visualization and streamlines the surgical process, benefiting both patient and surgeon.