T2 proximal humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. With a fixednail, 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 fda just cleared orthopedic designs north america, inc. Apr 22, 2014 treatment of proximal humeral fractures with polarus nail fixation. Surgical technique multiloc humeral nailing system 2 ao principles 4 indications 5 screw configuration 6 multiloc proximal humeral nail short 6 multiloc humeral nail long 8 clinical cases 10 preoperative planning patient positioning and approach 14 entry point 18 opening of the humerus 20 open medullary canal 20 reduce fracture and ream. 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. The trigen humeral nail system is designed specifically for the treatment of proximal humeral fractures and humeral shaft fractures, and is indicated for the repair of nonunions, malalignments, pathological humeral fractures, and impending pathological fractures. Comparative study between locking plates versus proximal. The periosteum reacts to the increased blood flow by forming new bone16, which in turn aids in heal ing of the nonunion figs. Unique proximal screw configuration enhances fragment fixation 4. Insert polarus cap place the cap assembly onto the 3. Trigen humeral intramedullary nail bmt medical devices. The titanium flexible humeral nail system technique guide.
Flexible intramedullary nailing for treatment of proximal. There are some key considerations to this approach. 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 provides new possibilities for the treatment of proximal humeral fractures and humeral shaft fractures. Straight proximal humeral nails are surrounded by more bone. Inserted in a reduced diameter and expanded within the medullary canal. Pdf intramedullary nailing of the proximal humerus. Jul 16, 2008 from january 2001 to april 2006, 54 shoulders of 54 patients 44 females, 10 males underwent the intramedullary fixation using polarus humeral nail. The centronail titanium humeral nailing system orthofix. Solid humeral nail uhn and proximal humeral nail phn.
Four proximal locking holes strategically placed to enable locking of separate fragments of the lesser tuberosity, the greater tuberosity and the humeral head. Versanail humeral proximal nailing system 4 the humeral proximal nail is designed to treat proximal humeral fractures. The system consists of short and long nails with multiple screw options to address simple and complex fractures of the proximal humerus as well as humeral shaft. Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. Intramedullary nail versus plate fixation for humeral. Pdf internal fixation of proximal humeral fractures with. Trigen humeral nail surgical technique pdf writer telegraph. Jul 29, 2015 the best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. Treatment of pathological humeral shaft fractures with. Antegrade and retrograde nail insertion are equally popular. Four multiplanar proximal locks to improve fracture stability. Internal fixation of proximal humeral fractures with a. The aequalis humeral nail system is intended to provide temporary stabilization of various types of proximal andor diaphyseal fractures of the humerus. Fixation is often difficult to satisfactorily achieve around the intramedullary device, whilst minimising soft tissue disruption.
This metaanalysis compared the clinical outcomes of locking plate with intramedullary nail in the treatment of displaced proximal humeral fractures. Surgical technique implant selection the trigen tan 71180884 and trigen fan 71180497 radiographic templates may be used to assist with preoperative implant selection. 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. San diego shoulder institute 2019 choosing to nail is the best approach to shoulder fracture. Versanail humeral universal nailing system nail 10 figure 9 figure 10 image intensification can be used to place a kwire through the humeral head in line with the intramedullary axis of the humerus figure 9. Between 1997 and 2005, 99 acute fractures of the humeral shaft were treated operatively with the unreamed humeral nail uhn, synthes in our level i trauma centre. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological. Trigen humeral intramedullary nail the trigen humeral intramedullary nail brings the simplified instrumentation of the trigen nail system to the hindfoot. Precice unyte humeral nail is an adjustable, stateoftheart device that utilizes a remote control to noninvasively compress and distract the humerus to ensure consolidation of open or closed fractures, nonunions or malunions. The humeral nail of medimetal was developed to treat variously located diaphyseal fractures. The selection of the implant was not randomized, but it was surgeon choice.
Descriptions of such cases in the current literature are very rare. Verify the position of the nail with the image intensifier. Insert the nail until the nail tip protrudes only slightly into the humeral head. The trigen hfn features an oblique locking configuration that allows surgeons to maximize thread purchase by locking into better bone. The role of nailing as opposed to plating of humeral fractures is the subject of continuous debate. 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. 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. Using a humeral intramedullary fixation nail hifn for humeral fractures is one of effective mis minimally invasive surgery methods, and this kind of surgery can usually provide the patient with an early recovery 1,2. Mean age of the patients was 66yearold 3989 at the time of the surgery. Nail length, locking screw length and nail cap size may be determined. Pdf internal fixation of proximal humeral fractures with a. There were 15 patients operated with the nhpt2 nail group a and 14.
Centronail humeral nailing system humeral nailing system one design for left or right humerus proximal bend 15 proximal humeral nail. 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. Retrograde single elastic intramedullary nail in closed. Metaanalysis of locking plate versus intramedullary nail. The primary tumors included carcinomas of breast 11, kidney 2, multiple myeloma 2, colon 2, prostate 1. The trapezoidal nail profile provides enhanced rotational stability in the humerus and adds a smaller dimension to the nail profile in the ap. Humeral nail designs have undergone significant innovation during the past 40 years and now can provide stable fixation in the humeral shaft distally as well as improved stability in the head and. Distal humeral periprosthetic fractures below intramedullary nail devices are complex and challenging to treat, in particular due to the osteopenicporotic nature of bone found in these patients. Humeral nail system cleared in under 30 days orthopedics. Proximal humeral fractures and intramedullary nailing.
The trigen humeral intramedullary nail brings the simplified instrumentation of the trigen nail system to the hindfoot. The first is to use the joysticks to extend and adduct the hu. Proximal humeral nail diaphyseal humeral nail 79 mm 5. A second nail driving guide wire of the same length is used to measure the length of the medullary canal figure 7. Entry portal for a straight nail is 5 mm posterior to the.
Intramedullary nailing group and stefaan nijs from the upper extremity group discuss the benefits of using the multiloc nail in proximal humeral fracture fixation in high and low energy trauma. The aim of this study is to compare the functional and radiological results of philos plate and nhpt2 nail for the treatment of displaced 2part proximal humeral fractures. Advance the cap until the polyethylene fully engages the threads of the. A new proximal humeral nail with multiple screw placement option. The purpose of this study is to analyze the results of intramedullary fixation of pathological humeral shaft fractures using an unreamed humeral nail uhn. The proximal locking holes in the nail are threaded. Internal fixation of proximal humeral fractures with a polarus humeral nail article pdf available in journal of orthopaedics and traumatology 93. Distal locking screws for the 18cm or longer humeral nails should be targeted using a freehand technique. Operative time for humeral shaft fractures was significantly lower than for proximal humeral injuries p 0. Short 150 mm and long 185320 mm, in 15 mm increments. Most of the hifns shown in korea are mainly foreignmade ones.
In two cases 8%, prominent protruding screws due to backout following vigorous physiotherapy were removed at 8 weeks with no adverse effects. An expandable self locking nailing system no distal screws required. The agency received the clearance request on january 26, 2018 and notified the company on february 22, 2018. Development of humeral intramedullary fixation nail hifn based on korean cadaveric tests 1changsoo chon, 2cheolwoong ko and 3jongkeon oh 1biomedical engineering institute, solco biomedical co. The titanium flexible humeral nail system technique guide for antegrade or retrograde insertion synthes on. The nails adapt to the contours of the medullary canal. Trigen humeral nailing includes a 16cm proximal straight nail, a 16cm proximal bent nail, and a full line of long bent nails. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological humeral fractures, and impending pathological fractures. Additionally, the centrally placed intramedullary nail func tions as an additional point of fixation for the humeral head, increasing the stability of the fracture.
Techniquenail insertion for pediatric femur opening the femur creating the nail entry point make an incision on the lateral or medial aspect of the distal femur, starting 3 cm above the physis and extending distally for 2. The mean total operative time was 56 21103 min for the humeral shaft fractures, 67 39120 min for proximal humeral fractures and 71 341 min for proximal humeral physeal injuries. Fracturetype by neer classification was 2part 29 shoulders, 3part 22 shoulders and 4part 3 shoulders. Get info of suppliers, manufacturers, exporters, traders of humerus nail for buying in india. Uniflex humeral nail surgical technique zimmer biomet. If necessary, check the position of the nail tip with the image intensifier. Intramedullary fixation of proximal humerus fractures. The presentation pays particular attention to the screwinscrew technique and. Jun 30, 2009 the goal of this study was to evaluate fracture healing and alignment as well as functional outcome and complication risks after internal fixation with the intramedullary proximal humeral nail phn. 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. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. It can be used universally for either the left or right humerus.
Protruding proximal nail causing impingement was observed in one case 4% due to improper countersinking of the nail end into the humeral head. The titanium flexible humeral nail system technique guide for. The laser marking on the end of the nail shows the nail tip. Between may 2005 and june 2006, we operated 29 2part humeral fractures. Insert the nail into the medullary cavity with the nail tip at right angles to the bone shaft 1.
Internal fixation of proximal humerus fractures using the t2proximal humeral nail. Org volume 89a number 1 january 2007 exchange nailing of ununited fractures turns to normal or supranormal levels within days after medullary reaming16,2022. Note as template magnification levels are set at 117%, all measurements are estimates of true size. If xrays show a very narrow intramedullary canal in the distal part of the humerus, retrograde humeral nailing is not possible. Popescu d, fernandezvalencia ja, rios m, cune j, domingo a, prat s. Retrograde single elastic intramedullary nail in closed simple diaphyseal humeral shaft fractures in children mohamed m h elsayed md1, ahmed f.
Find here online price details of companies selling humerus nail. We searched pubmed, embase, and the cochrane databases for studies comparing locking plate and intramedullary nail treatment of displaced two, three, or fourpart proximal humeral fractures. This device shows promise for applications involving the reconstruction of the humeral shaft and head with minimal soft tissue stripping and for providing a locked, fixedangle construct for. The titanium flexible humeral nail system technique guide for antegrade or retrograde insertion.
The t2 proximal humeral nail is intended for single use only. Intramedullary nail for proximal humerus fractures. This allows the insertion of a lateromedial locking bolt into the humeral head distally to the rotator cuff. Examples of specific indications according to ao classification include type afractures, dislo.
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