Comparison Of SURESHOT Distal Targeting System And Free-hand Technique Locking Intramedullary Nail Treatment Of Tibial Fractures

Objective: In this research, we aimed to retrospective analysis aimed tibialintramedullary nail in the magnetic navigation technology and freehand lockingcompare tibial intramedullary nail in surgical treatment of tibial shaft fractures. For thetreatment of tibial shaft fractures orthopedic surgeons to provide selected on the basissurgical solutions.Methods: For January2010-2014January First Affiliated Hospital of DalianMedical University, orthopedic trauma treated156cases of tibial shaft fracture patients(patients met the following criteria: Age≧20years old and≦70-year-old needssurgery treatment of adult patients with intramedullary nail), were retrospectivelyanalyzed. The intramedullary nail using electromagnetic navigation and freehandlocking intramedullary nail fixation method of treatment of tibial shaft fracture patientswere divided into two groups: A group of75cases, the use of electromagneticnavigation intramedullary nail treatment; group B81cases, the use of freehand lockingintramedullary nail. Comparison of two methods of remote surgery two successful timelocking nail (nail from the nail to complete insertion into perspective began to confirmthe position of the second piece of good distal locking screw up), a one-time successrate and fluoroscopy times locked. Johner-Wruhs postoperative follow-up evaluation, comparing the two limb function in patients with intramedullary nail treatment recovery.Inspection electromagnetic navigation in intramedullary nailing of tibial shaft fracturesadvantage.Results:For all156cases, the patient tibial intramedullary nail fixation wereanalyzed, remote locking nail two successful time: A group of8.7±2.0min (6.5-13min),group B20.5±5.2min (12-27min), the difference was statistically significant (P <0.05);disposable locking success rate: A group of70cases of distal locking is successful, fivecases of distal locking failure, remote locking nail a success rate of94%. group B63cases remote locking is successful,18cases of distal locking failure77%, the differencewas statistically significant (P <0.05); A group of distal locking nail mean intraoperativefluoroscopy time4.6±2.8sec (range1-10seconds) B group mean intraoperativefluoroscopy time19.4±8.2sec (range6-33seconds), the difference was statisticallysignificant (P <0.05); follow-up period from March to December, the average (10.6±0.4) months, fracture healing time: A group (16.7±1.8) weeks, B group (16.9±1.6)weeks, the difference was not statistically significant (P>0.05); Johner-Wruhs ratedexcellent rate: A group96.4%, group B93.5%, the difference was not statisticallysignificant (P>0.05).Conclusion: Two kinds of intramedullary nailing of tibial shaft fracture treatmentmethods have achieved a good cure rate and long-term treatment. electromagneticNavigation intramedullary nailing in the treatment of tibial bone and freehand lockingintramedullary nail comparison:1) electromagnetic Navigation System to nail distallocking intramedullary nail, easy operation, intraoperative positioning accuracy,significantly improves the remote lock the success rate of the nail; completion of2)electromagnetic navigation under the intramedullary nail distal locking screws, reducingthe number of C-arm X-ray continuous fluoroscopy, reducing radiation damage todoctors and patients.3) electromagnetic Navigation system improvements to reduce thenumber of punch when remote locking, reduce patient surgical trauma, easy to heal thewound surface, reflecting the minimally invasive principle. An ideal remote lockingsystem with a more broad application prospects.