Orthopaedic and Trauma Department, Hospital of Wallis, Sion, Switzerland.
J Orthop Trauma. 2012 Nov;26(11):633-7. doi: 10.1097/BOT.0b013e318242d8b7.
The purpose of this study was to assess the effectiveness of a novel radiation-independent aiming device for distal locking of intramedullary nails in a human cadaver model.
A new targeting system was used in 25 intact human cadaver femora for the distal locking procedure after insertion of an intramedullary nail. The number of successful screw placements and the time needed for this locking procedure were recorded. The accuracy of the aiming process was evaluated by computed tomography.
The duration of the distal locking process was 8.0 ± 1.8 minutes (mean ± SD; range, 4-11 minutes). None of the screw placements required fluoroscopic guidance. Computed tomography revealed high accuracy of the locking process. The incidence angle (α) of the locking screws through the distal locking holes of the nail was 86.8° ± 5.0° (mean ± SD; range, 80°-96°). Targeting failed in 1 static locking screw because of a material defect in the drilling sleeve.
This cadaver study indicated that an aiming arm-based targeting device is highly reliable and accurate. The promising results suggest that it will help to decrease radiation exposure compared with the traditional "free-hand technique."
本研究旨在评估一种新型的、不依赖射线的瞄准装置在人体尸体模型中用于髓内钉远端锁定的有效性。
在 25 个完整的人体尸体股骨中，在插入髓内钉后，使用新的瞄准系统进行远端锁定操作。记录成功放置螺钉的数量和完成该锁定操作所需的时间。通过计算机断层扫描评估瞄准过程的准确性。
远端锁定过程的持续时间为 8.0±1.8 分钟（平均值±标准差；范围，4-11 分钟）。无需进行透视引导即可完成螺钉的放置。计算机断层扫描显示锁定过程具有很高的准确性。锁定螺钉通过钉远端锁定孔的入射角度（α）为 86.8°±5.0°（平均值±标准差；范围，80°-96°）。由于钻套的材料缺陷，1 个静态锁定螺钉的定位失败。
这项尸体研究表明，基于瞄准臂的瞄准装置具有高度的可靠性和准确性。有前景的结果表明，与传统的“徒手技术”相比，它将有助于减少辐射暴露。
