Objectives: Intramedullary nailing is still the gold standard surgical technique in treatment of long bone diaphyseal fractures. In this surcigal procedure, distal locking phase gives rise to increased operative durations and flouroscopy time. Various device and techniques has been developed to overcome this issue. In our study, we aimed to investigate a practical and inexpensive technique for insertion of distal locking screws in intramedullary nailing of long bone diaphyseal fractures. Methods: 90 patients with diaphyseal fractures of tibia(48) and femur(42) who underwent intramedullary nailing were enrolled for this study. Classical Free Hand Locking (FHL) and Guidewire Assisted Locking (GAL) techniques were performed in distal locking phase of the procedure on 51 and 39 cases, respectively. These techniques were compared according to the influence on total operative duration and c-arm flouroscopy time. Results: GAL technique compared to FHL technique was provided statistically significant reduction in operative duration of both femur fractre surgery (75 vs 93 min., p<0,05) and tibia fracture surgery (63,5 vs 83 min, p<0,05). Flouroscopy time was also significantly lower in both femur (9 vs42,5 sec., p<0,05) and tibia (11 vs 38 sec., p<0,05) cases when utilizing GAL technique. Conclusion: GAL technique facilitates the distal locking phase of intarmedullary nailing surgery. It is an inexpensive and practical technique which reduces operative duration related complications and ionizing radiation exposure of surgical team. Keywords: Distal locking, femur fractures, flouroscopy, intramedullary nailing, tibia fractures
Corresponding Author: Alican Baris