Intramedullary fixation of proximal humerus fractures. Patients were treated with anterograde locked intramedullary nailing. One implant, two approaches stryker osteosynthesis has created a locking nail system, bringing together all the capabilities and benefits of separate antegrade and retrograde nailing. Flinkkila, tapio, intramedullary nailing of humeral shaft fractures division of orthopaedic and trauma surgery, department of surgery, university of oulu, p. Instruments and implants approved by the ao foundation. Smith and nephew, usa has been introduced to inhibit loosening failure of osteoporotic bone. These line additions are comprised of retrograde femoral, supracondylar, and tibial intramedullary nails and a nail cap. Exposure and nail insertion were performed using the surgical technique. Trigen humeral nail surgical technique pdf writer telegraph.
Final seating of the screw should always be under manual control using the straight ratcheting driver to avoid over insertion of the screw in osteoporotic bone. Use the humeral nail guide bolt to attach the nail drill guide to the broach figure 6. Small diameter intramedullary implant that requires only a 10mm. For the proximal humerus, the selflocking screw type of the im nail trigen humeral nail. One implant, two approaches stryker trauma has created a new generation locking nail system, bringing together all the capabilities and. Trigen humeral nailing includes a 16cm proximal straight nail, a 16cm proximal bent nail, and a full line of long bent nails this website uses cookies to help you get the most out of your experience during your visit, and we can improve the content served to you by collecting statistical information.
In this study we introduce a new radiographic evaluation of the course and variation of the radial nerve in the distal part of the. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological humeral fractures, and impending pathological fractures. Fractures of the proximal humerus including 2part surgical neck fractures, 3part fractures and 4part fractures fractures of the proximal humerus with diaphyseal extension diaphyseal fractures of the humeral. Trigen humeral nail proximal and long trigen hindfoot nail. The modern technique of intramedullary nailing was largely developed and perfected by the dedicated work of the german surgeons gerhard kuntscher and his student, richard maatz.
Note as template magnification levels are set at 117%, all measurements are estimates of true size. Orthopaedic division 1450 east brooks road memphis, tn 3 8 1 16 901 3995153 name of device. This case demonstrates a softtissue sparing technique of humeral shaft fixation using a humeral intramedullary nail. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. The trigen humeral nail provides new possibilities for the treatment of proximal humeral fractures and humeral shaft fractures.
Iatrogenic nerve injury during fracture surgery of the upper arm is a wellknown complication. Apr 21, 2017 the unreamed humeral nail uhn duration. With a fixed nail, fractures at the supracondylar area have occurred as result of the eccentric insertion of the nail, the narrow humeral canal and the stiffness of the nail. The sureshot system is a realtime imaging system that works with trigen im nailing systems. The trigen hfn features an oblique locking configuration that allows surgeons to maximize thread purchase by locking into better bone. Mar 16, 2009 twentyfour proximal humeral fractures were treated by surgical internal fixation with a locked antegrade intramedullary nail. Versanail humeral proximal nailing system zimmer biomet.
An insafelock humeral nail was used for each right humerus and a trigen humeral nail was used for each left humerus. The device is indicated for degeneration, deformity, or trauma of both the tibiotalar and talocalcaneal articulations in the hindfoot. The system combines the principles of a compression hip screw with the biomechanical advantage of an intramedullary nail. The first and only virtual realtime imaging system for distal locking, new technology that offers full surgeon control, a reduction in radiation exposure, and shorter procedures from im nailing. The intertan system offers anatomically shaped trapezoidal implants as opposed to conventional circular shaped intramedullary nails. Intramedullary nails used in trauma surgeries as internal fixation for different indications intertrochanteric fractures, retrograde femoral fracture, hindfoot fractures, tibial fractures. Surgical technique for the trigen humeral nail system. Box 5000, fin90014 university of oulu, finland 2004 oulu, finland abstract although nonoperative treatment is recognized as an effective treatment method for humeral shaft. This allows the insertion of a lateromedial locking bolt into the humeral head distally to the rotator cuff.
The t2 humeral nail offers multiple locking modes static, controlled dynamic and compression locking options to allow for ease of use and versatility in care. Humeral nail designs have undergone significant innovation during the past 40 years and now can provide stable fixation in the humeral shaft. Surgical technique for the trigen humeral nail system using the trigen. Download download tetraplegia and paraplegia pdf file read online read online tetraplegia and paraplegia pdf file the purpose of this book has always been to act as a manual for physiotherapists faced with the challenge of treating patients with tetraplegia and paraplegia. Insafelock humeral nail provides a safe application for.
The technique is easy to perform and has significant ota video library humeral shaft fracture. Locking blade nail click to download file life medical. The broaching method utilizes the noncylindrical shape of the proximal body of the nail to help rotationally stabilize the nail during insertion of the locking screws. In conclusion, the trigen intramedullary humeral nail is effective for the treatment of proximal humeral fractures.
The trigen humeral nail system is indicated for proximal andor diaphyseal fractures of the humerus, nonunions, malalignments, pathological humeral fractures. The retrograde nail length is deter mined by measuring the distance from 1cm above the olecranon fossa to the center of the humeral head. Intertan interlocking trochanteric nail technique 2. Since professor kuntscher and his team were working within germany during world war ii, their work remained largely unknown to the rest of the. Russelltaylor deltatibial interlocking nail technique 598 kb recon interlocking. Pdf intramedullary nailing of the proximal humerus. The proper nail length when inserted antegrade should extend from sub chondral bone proximally, to 1cm above the olecranon fossa distally. The t2 humeral nailing system is systems to offer an option for either an antegrade or a retrograde approach to repair fractures of the humerus. With multiplanar screws that are threaded into the nail to inhibit proximal screw backout, and effective, simple instrumentation that helps protect soft tissues, the trigen system now offers an effective.
T2 proximal humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. Trigen intramedullary nails are designed to reduce radiation, increasing. All measurements must be verified intraoperatively. Solid humeral nail uhn and proximal humeral nail phn. Insert the nail until the nail tip protrudes only slightly into the humeral head. The trigen intertan nail preoperative template set 71674200 may be used to assist with preoperative implant selection. A new approach for the treatment of proximal humeral. This publication is not intended for distribution in the usa. Centronail humeral instruments box, complete 1789911.
Secondary complications were minimal and observed in only 6 of 54 patients. There is a unique thread inside the hole to make a locking mechanism between the im nail and proximal screws. A deep understanding of the anatomical and biomechanical characteristics of the humerus is essential for arriving at decisions about important issues such as nail selection criteria, operative technique, and a rehabilitation program, whenever intramedullary nailing of diaphyseal humeral fractures is contemplated. Short and long humeral nail medin proximal humeral nails. The purpose of this paper was to assess the clinical outcomes of proximal epiphyseal and diaphyseal humeral fractures treated with an antegrade humeral nail implanted after an interval rotator split. Lenguaje oral definicion pdf, trigen humeral nail surgical. These views are not to scale and should be used as a pictorial representation only. The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. Versanail humeral proximal nailing system 3 intramedullary fixation of humeral proximal fractures the versanail humeral proximal nail is part of a long bone nailing system that offers a complete portfolio of implants and instruments based on a single, standardized technology platform. The t2 tibial nailing system is the realization of superior biomechanical intramedullary stabilization using small caliber, strong cannulated. May 21, 20 the mean neckshaft angle 1 year after surgery was 125 8. Trigen humeral intramedullary nail the trigen humeral intramedullary nail brings the simplified instrumentation of the trigen nail system to the hindfoot. Jointpreserving palliative surgery using selflocking. Trigen meta nail tibia trigen meta nail femur trigen knee nail retrograde femoral technique 3.
The humeral nail system can be used with or without the sureshot distal targeting system. The aim of the study was to stress out the complexity of appropriate operative treatment of humeral shaft fractures using intramedullary fixation, as well as the importance of proper reduction and stable fixation. Proximal andor diaphyseal fractures of the humerus nonunions. Cortical screw locks nail to humeral shaft preventing. Trigen intramedullary nailing system trigen sureshot distal targeting system trigen meta nail retrograde femoral nail trigen meta nail tibial nail trigen meta nail nailing in extension instrumentation trigen fan femoral antegrade nails trigen tan trochanteric nails trigen intertan intertrochanteric antegrade nail trigen hindfoot fusion nail trigen humeral nail with. Humerus nail and expert phn, the smith and nephew trigen phn. Trigen sureshot is a computer based system used to aid the surgeon with drilling position for distal screws during intramedullary nail surgery. Verify the position of the nail with the image intensifier. The t2 proximal humeral nail is intended to be used for various types of proximal andor diaphyseal fractures of the humerus. The trigen humeral nail with its versatile screw configuration was shown in a cadaver study to be one of the safest humeral nails for avoiding axillary nerve damage3 the trigen humeral nail system with sureshot technology is designed to distal lock the nail first, using the electromagnetic wand and perfect circles method for fewer.
Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a number of unique features. Trigen humeral intramedullary nail bmt medical devices. Expert humeral nail and expert proximal humeral nail. Versanail humeral universal nailing system 3 one implant designed for the efficient treatment of a range of humeral fractures the versanail humeral universal nail is part of a long bone nailing system that offers a complete portfolio of implants and instruments based on a single, standardized technology platform. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological. Descriptive data of the different nails tested can be found in table 1. The trigen humeral nail system is indicated for proximal andor diaphyseal fractures of the humerus, nonunions. From january 2004 to december 2008, 64 elderly patients age 60 years old with displaced proximal humeral fractures were treated using trigen phn.
The distal locking was successful obtained in all patients of group 2, while in two patients of group 1 polarus nail a missing of distal locking screw placement was noted. Six different commercially available proximal humeral nails were. The trigen intertan nail was designed as a trochanteric portal intramedullary nail especially shaped for fractures of the proximal femur. Diaphyseal humeral fractures and intramedullary nailing. Utilizing the same trigen instruments, the tan was developed to simplify the surgical approach by allowing placement of the nail through the greater trochanter instead of the piriformis fossa. We treated six proximal epiphyseal fractures and seven bifocal. The three types of internal fixationwere applied following the standardized surgical procedures.
Telegraph antegrade nailing in the treatment of humeral. However, we found the application of the distal locking screws in the trigen humeral nail with fluoroscopic guidewire and freehand technique with prolonged duration and similar safety design when compared with. Treatment of pathological humeral shaft fractures with. Expert humeral nail antegrade insertion position the image intensi. Multiloc humeral nails provide a comprehensive system for the treatment of. Surgical technique instruments and implants approved by the ao foundation. Once the nails were placed, proximal and distal region of the nails were dissected to evaluate the relationship between screws and adjacent anatomical structures. Trigen humeral nails have a favor in terms of safety against the other nails in the market. Electromagnetic distal targeting system does not reduce. The literature describes several methods to reduce this type of injury, but no perfect solution is at hand. The purpose of this study was to evaluate the functional outcome of using the trigen proximal humeral nail phn for the treatment of displaced proximal humeral fractures in elderly patients. An external file that holds a picture, illustration, etc. The possibility of compression or dynamisation must be taken into account when determining the tibial nail length and a correspondingly shorter nail should be chosen. The t2 proximal humeral nail is intended for single use only.
The nail is titanium and is intended to be inserted from proximal to distal. Trigen humeral nail antegrade mode only specifications driving end of nail proximal lock nondriving end of nail distal lock 18 28 lengths note. Pdf intramedullary nailing of humeral shaft fractures. This brochure is presented to demonstrate the surgical technique. The trigen humeral intramedullary nail brings the simplified instrumentation of the trigen nail system to the hindfoot. The humeral nail of medimetal was developed to treat variously located diaphyseal fractures. The proximal humerus can also be prepared by using the humeral broach. Besides, the simpler upper third fractures can also be treated as the proximal end of the nail provides three horizontal and an oblique locking positions.
Risk assessment of retrograde intramedullary nailing for. Jointpreserving palliative surgery using selflocking screws of. D device description the device is a stainless steel or titanium alloy nail for orthopaedic implantation. The humeral universal nail system from the versanail platform offers options to treat a range of humeral fractures using either the antegrade or retro. Surgical technique this publication is not intended for distribution in the usa.
The versanail humeral universal nail is part of a long bone nailing system that offers a complete portfolio of implants and instruments based on a single, standardized technology platform. Examples of specific indications according to ao classification include type afractures, dislo. The trigen knee fusion nail is one of the trigen series of intramedullary nails. Nail size, screw length and femoral neck angle may be determined. Modern proximal humeral nail designs and techniques assist the surgeon in adhering to. Jul 02, 2009 a consecutive series of 22 pathological fractures of the humeral shaft in 21 patients treated at one institution were included in this retrospective study. Uniflex humeral nail surgical technique the uniflex humeral nail system was developed in conjunction with ralph b. The course of the radial nerve in the distal humerus. Check the reduction and read off the required tibial nail length on the radiographic ruler as it appears in the xray. Conforms to shape of humeral head and prevents the ventrocranial nail protrusion. Do not operate the trigen sureshot targeter within 200mm of an installed pacemaker.