Tibia Nailing Without C-Arm Guidance: Challenges and Successes

Purpose There 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 materials This 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. Results All 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. Conclusions With 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.