Magnetic Equipped Wire Device-for Closed Interlocking Intramedullary Femoral Nailing: A Method That Avoids Exposure to Ionizing Radiations

Background: Intramedullary nailing is probably the best procedure for treating the long bone fractures in the lower limb. Such operationis guided by fluoroscopy for the guide-wire insertion like fracture reduction and distal locking. Radiation exposure during interlockednailing continues a matter of challenge. Objectives: The aim of this experimental study was to design and test the new aiming device for closed intramedullary nailing and toreduce the radiation exposure and the operation time during the procedure. Materials and Methods: A stainless steel femoral intramedullary guide wire equipped with a small magnet on its end was designed; andalso an exchange tube that would enter into the bone canal upon the guide wire to maintain the alignment. Besides these mentioned parts,we applied the standard classic interamedullary nailing set. Pin guide was inserted in the femoral intramedullary canal from periformisfossa. Another equipped magnetic guide wire was inserted from distal portal which was created in the lateral epicondyle. Two oppositemagnetic poles supposed to find each other in the fracture site. After replacing the guide-wire with guide pine; the alignment wouldbe checked by a C-arm. The study has been designed in 4 phases including moulage phase, animal phase on young cows, and a humancadaveric phase. The last step of the study is under design and it consists of a randomized controlled clinical trial on the elective patients. Results: Outcomes of applying the new system on 15 fiberglass artificial femurs and 20 bovine femurs as well as 10 human cadavericfemurs were successful. Conclusions: We found the magnetic field assistant device to be an accurate, radiation-independent jig for close passing of guide wireafter close reduction of femoral fracture. It can reduce the need for radiation during placement of guide wire for closed intramedullarynailing of the long bones. More studies are required to improve and evaluate the technique and equipment.

Keywords:

Intramedullary Nailing , Bone Fracture , Radiation , Magnet , Magnetic