Interlocking screws placed with freehand technique and uni-planar image intensification: the “dip-stick” technique

ObjectiveTo report our experience with a novel alternative method of freehand interlocking of intramedullary nails. This method requires the use of only anterior-posterior image intensification and an intramedullary guide wire to verify screw placement. Our results are compared with historical results in the literature.MethodsA total of 815 patients were treated using this technique from January 2008 to December 2012; 603 patients had fractures of the tibia and 212 had fractures of the femur.ResultsThe mean duration of surgery for tibial shaft fractures was 55.6 minutes (range 42–60 minutes) and that for fractures of the femur was 78 minutes (range 50–90 minutes). The mean time for each distal locking was 3.8 minutes (2.5–5.1 minutes), with 7.65 seconds of exposure to radiation during each block.ConclusionsThe surgical technique is simple, easy and reproducible. Mean time of surgery and radiation exposure was less than that in the literature. A comparative study should be performed.