From:  Distal locking of intramedullary nails with reduced radiation exposure and operating time using standard equipment

 The results of distal locking from the literature comparing free-hand and other targeting devices to our technique.

StudyTechniqueYearRadiation metric (as reported)Fluoroscopy time (s)Distal-locking time
Boraiah et al. [2]Free-hand2009Not reported28.9 ± 16.412.1 ± 3.2 min
Boraiah et al. [2]Targeting device2009Not reported9.2 ± 4.97.1 ± 2.4 min
Ehlinger et al. [3]Targeting device2013DAP 241.3 mGy/cm2*13.5 (median)Not reported
Maqungo et al. [4]Electromagnetic navigation2014Emitted dose 230.5 mGy711.0 min
Grimwood and Harvey-Lloyd [5]Electromagnetic navigation2016DAP reduction reported†103.28 min
Wang et al. [6]Free-hand2018Not reported2.13 ± 0.735.89 ± 2.02 min
Wang et al. [6]Electromagnetic navigation2018Effective dose 22.7 mSv40.41 ± 25.55Not reported
Davut and Doğramacı [10]Endoscopy-assisted2021Not reported23.73 min
Gao et al. [9]Laser navigation2022Not reported46.510.0 min
Shang and Wang [11]Kirschner wire technique2023Not reportedNot reported27.82 min
Menekse [12]Fluoroscopy-free202300Entire procedure‡
Deslivia et al. [13]Steinmann pin + hammer2024Lower vs free-hand§Not reportedShorter vs free-hand§
This studyProposed method2025DAP 4.43 cGy/cm211.5 ± 2.04.23 ± 1.2 min
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DAP: dose-area product. *: Radiation units are reported exactly as published; values were not converted unless explicitly stated in the original article. †: Grimwood and Harvey-Lloyd [5] reported relative reductions in DAP rather than absolute mean values. ‡: Menekse [12] reported fluoroscopy-free distal locking; operative time corresponds to the entire procedure, not isolated distal locking. §: Deslivia et al. [13] reported statistically significant reductions in radiation exposure and distal-locking time compared with free-hand technique (p < 0.05), but did not publish numerical mean values; therefore, only directional outcomes are reported here.