Straightforward, safe, and efficient interlocking screw insertion during intramedullary nailing using a Steinmann pin...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Techniques

Background:

• Distal interlocking screw placement during intramedullary nailing presents challenges.
• Accurate targeting of distal nail holes is crucial for successful outcomes.

Purpose of the Study:

• To introduce and evaluate a novel technique for distal locking screw insertion using a Steinmann pin.
• To compare this new method with the conventional freehand technique.

Main Methods:

• Eighteen Sawbones femur models were used with intramedullary nails.
• A first-year resident applied both conventional and Steinmann pin techniques for distal locking holes under image intensification.
• Evaluation metrics included time, radiation dose, and failure rates.

Main Results:

• The Steinmann pin technique resulted in significantly lower radiation doses (P=0.0268).
• Fewer failures were observed with the new technique (P=0.0367).
• The time to create distal holes was shorter with the Steinmann pin method (P=0.0217).

Conclusions:

• The Steinmann pin and hammer technique is an accurate and efficient method for creating distal interlocking holes.
• This novel approach offers a cost-effective alternative for orthopedic procedures.
• The technique simplifies distal locking screw insertion, potentially improving surgical workflow.