2023, Vol. 27 ›› Issue (18): 2866-2870

Insertion of distal interlocking of femoral intramedullary nails with vernier device

Liu Xu1, 2, Chen Hao1, 2, Kong Xiangru1, 2, Jiang Wei1, 2   

Abstract: BACKGROUND: Intramedullary nail is the “gold standard” for the treatment of femoral shaft fractures, but the placement of distal locking of the femoral intramedullary nail has always been a difficult problem.  
OBJECTIVE: To compare the effectiveness between unarmed and vernier device support groups for distal interlocking screws in femoral nails.
METHODS: Totally 63 patients with femoral shaft and trochanteric fractures (64 sides) were enrolled from Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital from 2017 to 2021. They were randomly divided into two groups. In the vernier device support group (32 cases), unarmed femoral intramedullary nail placement and internal fixation were conducted with vernier device support. In the unarmed group (32 cases), unarmed femoral intramedullary nail distal locking screw placement and internal fixation were conducted. The operation time and X-ray count for a perfect circle image, the time and the number of fluoroscopy when the nail was successfully placed, and the total time of the locking nail insertion were compared between unarmed and vernier device support groups.  
RESULTS AND CONCLUSION: The operation time and X-ray count for a perfect circle image of the vernier device support group were less than those in the unarmed group (P < 0.001). The time and the number of fluoroscopy when the nail was successfully placed of the vernier device support group were less than those in the unarmed group (P < 0.001). The total time of the locking nail insertion of the vernier device support group was less than that in the unarmed group (P < 0.001). The results show that, compared with the unarmed nail placement, the vernier device support placement has faster locking speed, less indirect radiation, no direct radiation exposure, and no need for a specially designed device. It is a locking nail technology worthy of promotion.
Key words: femoral fracture, intramedullary nail, interlocking screw, internal fixation, vernier device, unarmed nailing, magnetic navigation, extracorporeal diopter