Abstract
PurposeThere are increased trends in the last two to three decades to operate tibia fractures to ensure acceptable reduction over long period of time and to ensure early mobilization and return to work. This leads to frequent use of C-arm to perform the procedures. The purpose of our study is to reduce the exposure of radiation to the patient and healthcare workers during closed nailing of fractures.Methods and materialsThis is an institute-based retrospective cohort study. Patients operated with tibia interlocking nailing between November 2016 and November 2018 were shortlisted from the OT records. Seventy-six patients were shortlisted and their clinical records were retrieved. Fifty-eight patients fulfilling the inclusion criteria were included in the study. 28 patients had Tibia interlocking nailing done without using C-arm and 30 patients had tibia interlocking nailing done under C-arm guidance. IBM SPSS software was used to compare data between the groups using Chi-square test and Independent T-test with a 95% confidence interval to determine the significance.ResultsAll the patients progressed to the union by six months of surgery. Average blood loss, Infection rates and time to union in both the groups were comparable. Though the average duration of surgery was significantly higher in non-C-arm group as compared to with C arm group, when the duration of individual surgeries was analysed and plotted sequentially on a chart, we found it was comparable in later cases.ConclusionsWith adequate practice, tibial nailing without C-arm is easy, requires minimal manpower, equipment and can also prove to be a lifesaver in case of equipment failure.
Highlights
Tibia fracture is one of the common fractures in the younger age groups
The purpose of our study is to reduce the exposure of radiation to the patient and healthcare workers during closed nailing of fractures
Though the average duration of surgery was significantly higher in non-C-arm group as compared to with C arm group, when the duration of individual surgeries was analysed and plotted sequentially on a chart, we found it was comparable in later cases
Summary
Tibia fracture is one of the common fractures in the younger age groups. conservative treatment of tibia fractures has stood the test of time, still more and more fractures are being managed operatively with Interlocking nails to ensure acceptable reduction over a long period of time and to ensure early mobilization and return to work [1]. Risk of radiation exposure to surgeon and patient increases by 2.6 times while locking the nail distally [4,5] This has encouraged us to devise newer ways of minimizing radiation exposure over time, like distal targeting device, SIGN (surgical implant generation network) intramedullary nailing, magnetic manual targeting device, electromagnetic navigation, handheld guides, fluoroscopy based surgical navigation, expanding self-locking nail etc. These methods decrease radiation exposure, special and costlier equipment or Implants are required, not suited for resource-poor places. Our study is to compare the technique of tibia interlocking with and without C-arm in terms of variables like average duration of surgery, average blood loss during surgery, time to union and requirement of additional operative procedures if any
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