[Distal locking techniques without fluoroscopy in intramedullar nailing].

Area of Science:

• Orthopedic surgery
• Trauma surgery

Background:

• Intramedullary nailing is a common treatment for bone fractures.
• Distal locking is crucial for stabilizing the nail.
• Fluoroscopy is traditionally used for distal locking but has limitations.

Purpose of the Study:

• To present and evaluate three distal locking techniques and two checking methods for intramedullary nailing.
• To assess the efficacy of these techniques performed without fluoroscopy.

Main Methods:

• The study involved 501 femoral and 578 tibial fractures treated between 1999 and 2011.
• Distal locking was performed using bone alignment and aspiration techniques, with or without medial malleolus alignment, without fluoroscopy.
• Three specific distal locking techniques and two checking methods were employed.

Main Results:

• Successful distal locking was achieved in all but one case (99.9% success rate).
• The single failure was attributed to non-compliant distal screws with the surgical technique, leading to anterior nail placement.
• The combination of techniques allowed for efficient and accurate screw placement.

Conclusions:

• Distal locking in intramedullary nailing can be rapidly and effectively performed without fluoroscopy.
• A single technique or a combination of techniques and methods can be utilized.
• These findings offer a valuable alternative for distal locking in orthopedic trauma surgery.