Reducing radiation exposure in intra-medullary nailing procedures: Intra-medullary endo-transilluminating (iMET)

The purpose of the study was to reduce the level of radiation exposure during intra-medullary nailing procedures. A visible light source was inserted into the medullary bone cavity in order to detect the distal interlocking screw holes. The light penetrates out of the bone surface, revealing the position of the screw hole, and this allows the subsequent drilling and placing of the interlocking screw to be free of fluoroscopy. Among the 19 consecutive tibia-fracture patients recruited for this study, no repetition of the drilling procedure or insertion of a transverse interlocking screw was needed. The average time to finish the insertion of one distal interlocking screw was 4.1 ± 1.8 min. It was extrapolated that 13–41% of previous radiation exposure levels could be saved. The non-fluoroscopic approach thus decreases the health hazards that the patients are experiencing as well as those of the surgical team who need to perform such intra-medullary nailing operations on a routine basis.