Abstract

The success of interlocking nail is due to proximal and distal locking, giving stability to nail. For proximal locking we have inbuilt aiming system, but distal locking is done free hand. Free and method is associated with radiation exposure and time taking. In our study emphasized importance of mechanical aiming system for distal locking. Objectives: Our study is a comparative study between, distal locking by freehand method and distal locking by proximally mounted mechanical distal aiming device (DAD) with respect to radiation exposure and time taken. Methods: It was a prospective study conducted over a period of one and a half years. Cases under study were patient with mid-shaft femur fracture (type32 a simple). Comparison was done for c-arm shots and time required for distal locking. Results: A total of 140 patients were assessed. There were 70 patients in freehand group and 52 patients in DAD group. There was dramatic decrease in radiation exposure (free hand group – 13.5 c-arm shots, DAD group -2 c-arm shots) and time required (free hand group-22.4 min(mean), DAD group-7.8 min (mean)) for distal locking. There was also decrease in drill bit/nail graze in DAD group. Conclusion: Distal locking by free hand method is time taking and associated with radiation exposure. There is a learning curve for distal locking in free hand technique. But distal locking by DAD is user friendly just like proximal locking with decrease in locking time and radiation exposure.

Description