A simple, rapid and economical method of distal interlocking nailing in upper and lower leg intramedullary nailing

Distal interlocking of intramedullary nails is associated with a relatively high radiation exposure. For the reduction of fluoroscopy time and surgeon's hands irradiation, many devices have been developed so far. In this paper, a simple free-hand-technique is presented. The mean fluoroscopy time in 30 femur and 10 tibia interlocking intramedullary nailing procedures was one minute. The technique avoid the central beam of the fluoroscope and does not require specific instruments. The technique is based on the axial placement of a 2 mm K-wire in the interlocking screw holes. A centrally perforated 4.5 mm drill is placed over the K-wire. Therefore in this technique a perfect centrally placement of the K-wire is not necessary. The drill is guided by the K-wire thereby avoiding complications such as drill failure or deviation of the drill direction.