Is a Magnetic-Manual Targeting Device an Appealing Alternative for Distal Locking of Tibial Intramedullary Nails?

Abstract

BackgroundIn order to enable a radiation-free, accurate and simple positioning of distal locking screws, a combined magnetic and manual targeting system has been developed by Sanatmetal®. Where a low-frequency magnetic field is initially used to detect the position of the first drill hole and three more holes can be found with a mechanical template.ObjectivesOur cadaver study was performed to evaluate the accuracy and efficiency of this device.Materials and MethodsIn two runs, 30 probands (group 1: 10 students; group 2: 10 residents; group 3: 10 attendings), none of who being familiar with the device, tested the radiation-free system using 60 intact cadaver tibias. Each proband performed the surgical procedure twice in succession.ResultsReferring to the first attempts, 9.6, 7.2 and 7.1 minutes were the time periods required to insert the four distal screws and the relevant values for the second attempts were 8.6, 6.3 and 6.2 minutes; in both cases revealing a significant difference between group 1 and 2 and group 1 and 3. Furthermore, the mean values within each group indicated a significant decrease of the test duration. Out of the 240 drillings, only one failure (group 1) occurred, representing an accuracy of 99.58 %. Of the probands, 90 % rated the targeting device better than the free-hand technique and 77 % at least attested a high user-friendliness.ConclusionsDue to our satisfactory test results, the brief training, the steep learning curve and the radiation-free technique the new device has to be considered an appealing alternative for distal locking.

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

“…EMTS is one of the most common and most attainable ones of these new developments. There are several studies which compare free-hand and EMTS guided distal locking [24][25][26][27]. The main arguments are duration of surgery and radiation exposure in these studies.…”

Accuracy of Distal Long Femur Nail Locking with Different Techniques

“…However, Computer-assisted EM targeting and the inside-out method were significant superior than group II. Negrin and Vécsei have been reported that the Sanatmetal® targeting (Magnetic-Manual targeting) device has to be considered as an appealing alternative for distal locking [11]. It can be an alternative device but our statistical results is showing the superiority of inside-out and computer-assisted techniques.…”

“…Intramedullary nailing is known one of the most technically demanding procedures in orthopedic traumatology. Many technical properties and surgeon's skills determine the success of the surgery [11]. Incorrect screw placement is one of the most annoying problems for the intramedullary nailing.…”

Πειραματική Μελέτη Της Σταθερότητας Της Ενδομυελικής Ήλωσης Ασταθών Καταγμάτων Κνήμης Με Περιφερικούς Κοχλίες Διαφορετικού Αριθμού Και Θέσης

“…Μια πρώτη εκδοχή της τεχνικής έγινε εμπορικά διαθέσιμη από την Sanatmetal, μια μικρή ευρωπαϊκή εταιρεία και ο Negrin κ.συν. δοκιμάζοντας την σε πτωματικές κνήμες με χειρουργούς που δεν είχαν καμία εξοικείωση, βρήκε μόνο μία αποτυχία σε 240 προσπάθειες [132]. Στη συνέχεια ήρθε η εξέλιξη του συστήματος με τη μορφή που κυκλοφορεί ευρέως σήμερα, από την πολυεθνική εταιρεία Smith & Nephew.…”