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Related Experiment Video

Updated: Oct 20, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Tibia Nailing Without C-Arm Guidance: Challenges and Successes.

Brejesh K Prasad1, Rahul Jain1, Amit Kumar2

  • 1Orthopaedics, Employees' State Insurance Corporation Medical College, Faridabad, IND.

Cureus
|September 13, 2021
PubMed
Summary

Tibial nailing without C-arm (fluoroscopy) is a safe and effective alternative for fracture repair, reducing radiation exposure for patients and staff. With practice, surgical times become comparable to C-arm assisted procedures.

Keywords:
c armfractureradiationtak -tak techniquetibia interlocking

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Medical Imaging

Background:

  • Increasing trends in operating tibia fractures for long-term stability and early mobilization.
  • Frequent reliance on C-arm fluoroscopy during these procedures.
  • Concerns regarding radiation exposure to patients and healthcare workers.

Purpose of the Study:

  • To evaluate the efficacy and safety of performing closed tibial nailing without C-arm guidance.
  • To assess the potential for reducing radiation exposure during tibia fracture surgery.

Main Methods:

  • Retrospective cohort study of 58 patients undergoing tibia interlocking nailing.
  • Comparison between 28 patients operated without C-arm and 30 patients with C-arm guidance.
  • Statistical analysis using Chi-square and Independent T-test with 95% confidence interval.

Main Results:

  • All patients achieved union by six months post-surgery.
  • Comparable average blood loss, infection rates, and time to union between groups.
  • Initially longer surgery duration in the non-C-arm group, which became comparable with experience.

Conclusions:

  • Tibial nailing without C-arm is feasible, safe, and effective with adequate practice.
  • This technique requires minimal resources and can mitigate risks associated with C-arm use.
  • It offers a potential solution in situations of equipment failure or resource limitations.