Distal screw targeting of interlocking nails.

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Surgical instrumentation

Background:

• Distal interlocking screw placement in the Grosse-Kempf nail is challenging due to nail deformation and targeting device inaccuracy.
• Current methods can lead to procedural difficulties and increased fluoroscopic exposure.

Purpose of the Study:

• To introduce and evaluate an alternative technique for accurate distal interlocking screw placement.
• To reduce the complexity and radiation exposure associated with Grosse-Kempf nailing.

Main Methods:

• A novel technique using Kirschner wires (K-wires) as guides for distal interlocking screw placement.
• Utilizing a second Grosse-Kempf nail as a targeting guide for proximal K-wire insertion.
• Employing a cannulated drill over K-wires for cortex preparation before screw insertion.

Main Results:

• The technique was successfully applied in 25 consecutive cases (8 tibiae, 17 femora).
• The method proved easy to master for orthopedic surgeons.
• Significant reduction in roentgenogram exposure compared to freehand techniques was observed.

Conclusions:

• The described technique offers a simpler and safer alternative for distal interlocking of the Grosse-Kempf nail.
• This approach enhances accuracy and minimizes radiation exposure in tibial and femoral nailing procedures.
• Further adoption of this technique may improve patient outcomes and surgeon efficiency.