Electromagnetic distal targeting system does not reduce the overall operative time of the intramedullary nailing for humeral shaft fractures

Abstract

The use of the EM distal targeting system doesn't reduce the overall operative time of the humeral shaft fracture fixation using IMN.

Can the complications of distal locking be prevented with a new nail that offers a novel locking technique in the treatment of humeral shaft fractures?

“…Neurovascular and/or tendon damage, breaking of the drill, and bleeding have been reported during the distal locking stage in the treatment of humeral shaft fractures with conventional nails. [ 3 , 7 , 8 , 17 , 18 ] The distal humerus is rich in neurovascular anatomic structures; therefore, percutaneous distal locking may cause risks during conventional nailing. In their studies on cadaveric bones, Rupp et al[ 19 ] reported that the radial nerve is in direct risk in conventional nailing techniques where the distal locking is placed from lateral to medial in accordance with nail design.…”

“…In the literature, there are few studies reporting the results of electromagnetic systems in patients who underwent intramedullary nailing for humerus fractures. [ 8 , 17 , 18 ] Persiani et al[ 8 ] compared the electromagnetic system and freehand technique in terms of the time elapsed during the distal locking and exposure to radiation and the authors reported that the electromagnetic system significantly reduces the duration of distal locking and exposure to radiation, while causing additional cost. Antonini et al[ 17 ] reported an average distal locking time of 5.8 minutes for a single screw in their study using the electromagnetic system for humerus, femur, and tibia fractures.…”

“…Antonini et al[ 17 ] reported an average distal locking time of 5.8 minutes for a single screw in their study using the electromagnetic system for humerus, femur, and tibia fractures. Camarda et al[ 18 ] compared the electromagnetic system with freehand technique for distal locking and they reported no significant difference between the two techniques in terms of total duration of surgery. Tasci et al[ 9 ] compared InSafeLOCK® and Trigen (Smith & Nephew, Memphis, TN, USA) nails on cadavers in terms of the application durations.…”

A new method of distal blocking of intramedullary implants

“…Нельзя не отметить высокую стоимость оборудования для реализации данных способов. По данным Lawrence Camarda и соавт., использование электромагнитных устройств для блокирования не уменьшает продолжительность операции по сравнению с техникой «свободной руки» [15]. При применении данного способа погрешность, то есть количество неправильно просверленных отверстий, по данным A. Allard, составляет 21,6% [16].…”

Reduced Surgical Time and Higher Accuracy of Distal Locking with the Electromagnetic Targeting System in Humeral Shaft Intramedullary Nailing

“…Although many studies focus on the use of EM in lower extremity fractures, there are few studies that compare the distal locking technique with intramedullary humeral nailing [32][33][34] . Camarda et al 35 reported that use of the EM technique was not able to significantly reduce the overall surgical time of the humeral shaft fixation. The finding was not in accordance with other studies on tibial or femoral fractures.…”