Reduced Surgical Time and Higher Accuracy of Distal Locking with the Electromagnetic Targeting System in Humeral Shaft Intramedullary Nailing

摘要

OBJECTIVE:To evaluate the efficacy of the electromagnetic distal targeting system in the treatment of humeral shaft fractures.METHODS:From January 2012 to December 2018, we retrospectively reviewed 60 patients with humeral shaft fractures treated by intramedullary nailing. Among 60 cases, 41 were men and 19 were women. The average age at surgery was 48.5?years (range, 21-81?years). We performed the same surgical procedure for all patients. According to the different distal locking technique used, all patients were divided into two groups. The standard fluoroscopic freehand technique was used for Group FH, while the electromagnetic real-time targeting technique was used for Group EM. All procedures were performed by two senior surgeons. Overall surgical time, cases of complications, failure of distal locking, union time, and shoulder function assessment were recorded intraoperatively and during follow-up.RESULTS:Twenty-seven patients in Group FH and 33 patients in Group EM met the inclusion criteria. No significant difference was found in the demographic data of the two groups. The mean surgical time was 76.48?±?10.73?min in Group FH and 65.61?±?8.91?min in Group EM (P ?0.05), showing significant difference. Seven failures occurred in Group FH and two failures occurred in Group EM (P ?0.05). No relevant complications were noted. The average union time was 3.37?±?0.49?months in Group FH and 3.39?±?0.50?months in Group EM (P = 0.855). The mean follow-up was 14.30?±?2.28?months in Group FH and 15.27?±?2.83?months in Group EM (P = 0.153). The disabilities of the arm, shoulder and hand score (DASH) score, the range of motion (checked with the constant score), and the degree of functionality were, respectively, 21.52?±?3.23, 27.04?±?1.84, and 81.31%?±?3.88% in Group FH and 19.09?±?2.40, 26.18?±?1.70, and 77.97%?±?3.91% in Group EM (P = 0.233, 0.971, and 0.607).CONCLUSION:The electromagnetic real-time targeting system reduced surgical time and improved accuracy, and there was no radiation exposure in the distal locking procedure for humeral shaft fractures.? 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.