Abstract
The free hand technique remains the most popular method for distal locking; however, radiation exposure is a major concern. In an endeavour to overcome this concern, distal locking with the nail over nail technique is evaluated. Seventy patients with femoral diaphyseal fractures treated by intramedullary nailing were divided in two groups for distal locking: either using the free hand technique (group I) or with the nail over nail technique (group II). The average number of images taken to achieve nail insertion without locking, for distal locking, and for the complete procedure in group I was 25.8, 24.2, and 50.08, respectively, compared with 24.8, 4.1, and 28.9, respectively, in group II (statistically extremely significant decrease in radiation). The nail over nail technique appears to be a reliable solution for decreasing radiation exposure during closed femoral intramedullary nailing. However, over-reaming of 1.5 mm is the key to the success of the technique.
Résumé
Le verrouillage à main levée est une technique populaire cependant, le problème de l’irradiation demeure important. Nous avons voulu l’évaluer lors du verrouillage des clous centro-médullaires. 70 patients présentant une fracture de la diaphyse fémorale ont été traités par enclouage centro-médullaire divisés en deux groupes, verrouillage distal à main levée (groupe I) et verrouillage selon la technique « nail over nail » (groupe II). le nombre d’image moyen nécessaire pour mettre en place le clou avec un verrouillage distal où lors de la procédure complète a été respectivement, pour le groupe I de 25,8, 24,2 et 50,08 comparé à 24,8, 4,1 et 28,9 pour le groupe II (différence extrêmement significative en ce qui concerne la diminution de l’irradiation). la technique « nail over nail » apparaît comme une technique fiable et permet une diminution de l’exposition aux rayons X lors de l’enclouage fémoral. Cependant, il est nécessaire de rappeler qu’un alésage supérieur à 1,5 mm est la clef du succès de cette technique.
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Rohilla, R., Singh, R., Magu, N. et al. Nail over nail technique for distal locking of femoral intramedullary nails. International Orthopaedics (SICOT) 33, 1107–1112 (2009). https://doi.org/10.1007/s00264-008-0579-y
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DOI: https://doi.org/10.1007/s00264-008-0579-y