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Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails.

Abstract Although the method has been used widely, one of the greatest challenges for intramedullary nailing is to position the distal locking screw. A new technology, the electromagnetic navigation system, is a radiation-free way to locate the position of the drill bit and provide 3-dimensional real-time feedback of location and orientation of the drill bit relative to the locking holes. The purpose of our study was to evaluate the reliability and efficiency of the free-hand technique compared to the new electromagnetic navigation system.
PMID
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Authors

Mayor MeshTerms

Bone Nails

Fluoroscopy

Fracture Fixation, Intramedullary

Surgery, Computer-Assisted

Keywords
Journal Title medicine
Publication Year Start




PMID- 28723755
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170728
LR  - 20170801
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in
      distal locking of femoral intramedullary nails.
PG  - e7450
LID - 10.1097/MD.0000000000007450 [doi]
AB  - BACKGROUND: Although the method has been used widely, one of the greatest
      challenges for intramedullary nailing is to position the distal locking screw. A 
      new technology, the electromagnetic navigation system, is a radiation-free way to
      locate the position of the drill bit and provide 3-dimensional real-time feedback
      of location and orientation of the drill bit relative to the locking holes. The
      purpose of our study was to evaluate the reliability and efficiency of the
      free-hand technique compared to the new electromagnetic navigation system.
      METHODS: Fifty-four patients with femoral fracture who needed treatment with
      intramedullary nails were divided into 2 groups. One group including 26 patients 
      underwent distal locking using the standard free-hand method, whereas the
      electromagnetic navigation system was used with the other 29 patients.
      Intraoperative fluoroscopy exposure times, screw insertion times, and healing
      times were recorded; these parameters were used for comparison between the 2
      groups. RESULTS: There were 17 males and 9 females who had femoral intramedullary
      nails using the free-hand technique, whereas 21 males and 8 females received
      intramedullary nails using the electromagnetic navigation system. The mean time
      of distal locking was 19.5 +/- 6.0 minutes in the free-hand (FH) group, whereas
      the time was 6.1 +/- 1.4 minutes in the electromagnetic (ET) group. The exposure 
      time for the FH group was 26.8 +/- 13.3 seconds and 2.2 +/- 1.1 seconds for the
      ET group. Healing time proved to be comparable in the FH and ET groups (16.4 +/- 
      3.7 weeks vs 15.1 +/- 2.8 weeks). CONCLUSION: Under the premise of achieving the 
      same effect, the electromagnetic navigation system has the advantage of less
      distal locking time and less radiation dose.
FAU - Han, Bing
AU  - Han B
AD  - Department of Orthopaedics, The Second Affiliated of Anhui Medical University,
      Hefei, Anhui, PR Chin.
FAU - Shi, Zhigang
AU  - Shi Z
FAU - Fu, Yu
AU  - Fu Y
FAU - Ye, Yong
AU  - Ye Y
FAU - Jing, Juehua
AU  - Jing J
FAU - Li, Jun
AU  - Li J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - *Bone Nails
MH  - Electromagnetic Phenomena
MH  - Female
MH  - Femoral Fractures/diagnostic imaging/*surgery
MH  - Femur/diagnostic imaging/surgery
MH  - *Fluoroscopy
MH  - *Fracture Fixation, Intramedullary
MH  - Humans
MH  - Male
MH  - Radiation Dosage
MH  - *Surgery, Computer-Assisted
MH  - Time Factors
PMC - PMC5521895
EDAT- 2017/07/21 06:00
MHDA- 2017/07/29 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007450 [doi]
AID - 00005792-201707210-00020 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7450. doi: 10.1097/MD.0000000000007450.