Objective: To develop a universal screwdriver for sealing the end of the central hole of the femoral interlocking intramedullary nail, so as to shorten the operation time of the tail cap implantation of the intramedullary nail and improve the accuracy of implantation.
Methods: Total 77 patients with intertrochanteric fractures underwent femoral interlocking intramedullary nail (FIIN) surgery from June 2018 to June 2019. There were 28 males and 49 females, aged 55 to 80 (76.22± 7.32) years old, and course of disease was 20 to 40 h. All patients were divided into universal screwdriver group (39 cases) and ordinary screwdriver group (38 cases) according to whether the self-developed universal screw was applicable during the operation. The blood loss during tail cap implantation, the time of tail cap implantation, the success rate of one-time implantation, and the postoperative curative effect were compared between two groups.
Results: All patients were followed up for 12 to 36 months, with an average of(20.00±6.38) months. The bleeding volume and the time of tail cap implantation in the universal screwdriver group were significantly lower thanthose in the ordinary screwdriver group (P<0.05);The one-time success rate (100%) of the universal screwdriver group was significantly higher than that of the ordinary screwdriver group (75.4%)(P< 0.05);at the last follow-up, the efficacy scores of two groups were improved compared with preoperatively, but the efficacy scores of the universal screwdriver group were significantly better than those of the ordinary screwdriver group(P<0.05).
Conclusion: The universal screwdriver is easy to operate during the operation when using the cap of the femoral intramedullary nail, the operation time is shortened, the amount of bleeding is reduced, and the treatment effect is satisfactory.
Keywords: Femoral fractures; Fracture fixation, intramedullary; Hip fractures; Screwdriver.