Evaluation of TRIGEN SURESHOT® distal targeting system - A new electromagnetic computer-assisted guidance system

Intramedullary nailing (IMN) remains the standard technique for the treatment of diaphyseal fractures of long bones. Recently, a new system has been introduced, TRIGEN SURESHOT®, designed by SMITH & NEPHEW, in which distal lockage of IMN no longer requires fluoroscopy. 102 patients (mean age 35.8) with closed diaphyseal fractures (34 femoral shaft and 68 tibial shaft fractures) were treated by IMN using the SURESHOT® for distal interlocking. The accuracy was 97.05%; intraoperative technical difficulties were encountured in 9 cases - 5 tibial and 4 femoral nails (1 antegrade and 3 retrograde). The average time of insertion of both distal interlocking screws was: 235.6 sec (between 228 and 246 sec) for antegrade femoral nails, 247.5 sec (between 236 and 268 sec) for retrograde femoral nails and 219.2 sec (between 202 and 251 sec) for tibial nails. This new method avoids exposure to ionizing radiation, while showing an accuracy of 96-100% and a low learning curve.