Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Distal Locking of Intramedullary Nailing in Tibial Shaft Fractures: A Comparison between Fluoroscopic and Electromagnetic Guidance

Gianluca Testa
* ORCID logo ,
Fabio Sammartino
,
Sebastiano Mangano
,
Luca Gurrieri
,
Gioele Vitaliti
ORCID logo ,
Marco Sapienza
ORCID logo ,
Vito Pavone
ORCID logo
Version 1 : Received: 10 April 2024 / Approved: 11 April 2024 / Online: 11 April 2024 (07:37:34 CEST)

How to cite: Testa, G.; Sammartino, F.; Mangano, S.; Gurrieri, L.; Vitaliti, G.; Sapienza, M.; Pavone, V. Distal Locking of Intramedullary Nailing in Tibial Shaft Fractures: A Comparison between Fluoroscopic and Electromagnetic Guidance. Preprints 2024, 2024040772. https://doi.org/10.20944/preprints202404.0772.v1 Testa, G.; Sammartino, F.; Mangano, S.; Gurrieri, L.; Vitaliti, G.; Sapienza, M.; Pavone, V. Distal Locking of Intramedullary Nailing in Tibial Shaft Fractures: A Comparison between Fluoroscopic and Electromagnetic Guidance. Preprints 2024, 2024040772. https://doi.org/10.20944/preprints202404.0772.v1

Abstract

Background: Tibial shaft fractures are the most common of long bone fractures. The gold standard for management is locked intramedullary nailing. The freehand method under fluoroscopic monitoring is the most often utilized method for distal screw locking. Electromagnetic guidance-based distal screw locking methods have gained popularity recently. The study's objective is to evaluate the system using electromagnetic tracking data against the free-hand technique. Methods: Sixty-three patients who received intramedullary nailing for tibial shaft fractures at our institute between January 2018 and May 2022, were included in this study. Two groups of patients were distinguished: Group FH underwent freehand distal locking and intramedullary nailing, while Group SS underwent electromagnetically guided locking. Radiation exposure period, as well as dose area product, were noted and statistically compared. Results: In terms of dose area product, a mean value of 43.57±31.57 cGy/cm2 in group FH and a mean value of 27.62±11.20 cGy/cm2 in group SS (p < 0.05) was assessed. Concerning the duration of surgery a mean value of 128.83±26.51 minutes was reported in group FH and a mean value of 126.42±48.31 minutes in group SS (p > 0.05). Conclusions: This study confirms the use of electromagnetic-guided locking distal screws reduces the total time of exposure to ionizing radiation, with no difference in operating time.

Keywords

tibial shaft fractures; locked intramedullary nailing; distal screw locking; freehand; sureshot

Subject

Medicine and Pharmacology, Orthopedics and Sports Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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